Seth Korbin1, Michael Salerno2, Justice U Achonu1, Mingqian Huang3, Paul Vaska2, Amanda Pawlak1, David E Komatsu4, James M Paci5. 1. Department of Orthopaedics, Stony Brook University Hospital, Stony Brook, New York, USA. 2. Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA. 3. Department of Radiology, Stony Brook University Hospital, Stony Brook, New York, USA. 4. Department of Orthopaedics, Stony Brook University Hospital, Stony Brook, New York, USA. David.Komatsu@stonybrookmedicine.edu. 5. Orlin & Cohen Orthopedic Group, Zucker School of Medicine at Hofstra/Northwell School of Medicine, Hempstead, New York, USA.
Abstract
PURPOSE: To use serial PET/MRI imaging to radiographically evaluate the metabolic activity of the ACL graft over the first post-operative year. METHODS: Six patients undergoing primary ACL reconstruction were recruited in this prospective study in an inpatient university hospital. All patients underwent femoral and tibial suspensory cortical fixation with quadrupled semitendinosus autograft hamstring ACL reconstruction by an orthopaedic surgeon. Simultaneous 18F-FDG PET and MRI of both the operative and non-operative knee was performed at three, six, and 12 months post-operatively. Quantification of the mean standardized uptake value (SUV) within the whole-knee, as well as tibial tunnel, femoral tunnel, and intra-articular graft regions of interest (ROIs). RESULTS: PET whole-knee activity was increased at all time-points post-operatively compared to the control, non-operative knee. Activity decreased over time, yet considerable generalized activity remained 1 year post-operatively, with relative intensity 34% percent higher than control. When the operative knee was divided into three whole-regions, there was greater activity in the tibia at three than 12 months, the femur at six than 12 months, and in the tibia compared to the intra-articular region at 3 months. When they were separated into sub-regions, results demonstrated greater activity closer to the joint surface. CONCLUSIONS: PET/MRI evaluation of ACL graft reconstructions demonstrates evolving biologic activity within the graft and both tunnels. Focal areas of increased activity within the tunnels may indicate of ligamento-osseous morphologic changes. These data suggest that graft incorporation continues well beyond 1 year post-operatively. LEVEL OF EVIDENCE: Level IV.
PURPOSE: To use serial PET/MRI imaging to radiographically evaluate the metabolic activity of the ACL graft over the first post-operative year. METHODS: Six patients undergoing primary ACL reconstruction were recruited in this prospective study in an inpatient university hospital. All patients underwent femoral and tibial suspensory cortical fixation with quadrupled semitendinosus autograft hamstring ACL reconstruction by an orthopaedic surgeon. Simultaneous 18F-FDG PET and MRI of both the operative and non-operative knee was performed at three, six, and 12 months post-operatively. Quantification of the mean standardized uptake value (SUV) within the whole-knee, as well as tibial tunnel, femoral tunnel, and intra-articular graft regions of interest (ROIs). RESULTS: PET whole-knee activity was increased at all time-points post-operatively compared to the control, non-operative knee. Activity decreased over time, yet considerable generalized activity remained 1 year post-operatively, with relative intensity 34% percent higher than control. When the operative knee was divided into three whole-regions, there was greater activity in the tibia at three than 12 months, the femur at six than 12 months, and in the tibia compared to the intra-articular region at 3 months. When they were separated into sub-regions, results demonstrated greater activity closer to the joint surface. CONCLUSIONS: PET/MRI evaluation of ACL graft reconstructions demonstrates evolving biologic activity within the graft and both tunnels. Focal areas of increased activity within the tunnels may indicate of ligamento-osseous morphologic changes. These data suggest that graft incorporation continues well beyond 1 year post-operatively. LEVEL OF EVIDENCE: Level IV.
Entities:
Keywords:
Anterior cruciate ligament; Autograft; Magnetic resonance imaging; Positron-emission tomography
Authors: Y Bangert; A Jaber; F Wünnemann; G Berrsche; N Streich; C Rehnitz; H Ott; A Barié Journal: BMC Musculoskelet Disord Date: 2020-12-18 Impact factor: 2.362