Can Preoperative Magnetic Resonance Imaging Predict Intraoperative Autograft Size for Anterior Cruciate Ligament Reconstruction? A Systematic Review

2018 ◽  
Vol 32 (07) ◽  
pp. 649-658 ◽  
Author(s):  
Suhail Agarwal ◽  
Darren de SA ◽  
Devin C. Peterson ◽  
Daniel Parmar ◽  
Nicole Simunovic ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Exclusion Criteria ◽  
Preoperative Magnetic Resonance ◽  
Anterior Cruciate ◽  
Mri Measurements

AbstractThis systematic review explored the utility of preoperative magnetic resonance imaging (MRI) as a tool for predicting intraoperative graft size for anterior cruciate ligament (ACL) reconstruction. Three databases (EMBASE, PubMed, and MEDLINE) were searched in November 2017 for English-language studies of all levels of evidence that aimed to correlate preoperative MRI measurements of common primary ACL autograft sources to intraoperative measurements of the harvested graft. Two reviewers applied predetermined inclusion/exclusion criteria to independently complete title, abstract, and full-text review of eligible studies. Data abstraction, quality assessment, and descriptive statistics are presented. A systematic screen of 930 titles resulted in 14 studies satisfying inclusion/exclusion criteria. These studies examined 762 patients of mean age 28.6 (9–67) years, with 37.3% females. Comparing the correlation of preoperative MRI measurements to intraoperative harvested measures, the strength was very highly positive for quadriceps tendon (QT) (one study, 29 patients, intraclass correlation coefficient [ICC] = 0.96), highly positive for patellar tendon (two studies, 28 patients, ICC: 0.77–0.87), negligible-highly positive for semitendinosus-only tendon (eight studies, 439 patients, r: 0.16–0.81), and negligible-moderately positive for gracilis-only tendon (four studies, 143 patients, r: 0.29–0.59). When combined semitendinosus–gracilis tendon grafts were considered, the correlation ranged from low-very highly positive (10 studies, 517 patients, r: 0.42–0.93). Preoperative MRI assessment of both QT and bone–patellar tendon–bone autografts most highly correlates with intraoperative measurements of autograft diameter. Considerable variability exists when viewing hamstring tendons either individually or together, where most studies indicate at least a moderate correlation. This highlights the advantage of MRI during the preoperative planning process in equipping the surgeon with a better ability to ensure the diameter of the intended autograft will suffice. This is a Level IV study, systematic review of Levels II to IV studies.

scholarly journals Accuracy of Magnetic Resonance Imaging in Diagnosis of Internal Derangement of the Knee

2016 ◽  
Vol 23 (4) ◽  
pp. 11-17 ◽  
Author(s):  
Mohammad M. Abbas ◽  
Abdullah A. Abulaban ◽  
Mamdooh M. Kotb
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Anterior Cruciate Ligament Injuries ◽  
Preoperative Magnetic Resonance ◽  
Anterior Cruciate ◽  
Operative Notes ◽  
Knee Pathology

The current study aims to assess the sensitivity and specifi city of magnetic resonance imaging by reference to arthroscopy in the preoperative diagnosis of knee pathologies. In this retrospective study, pre-operative knee magnetic resonance imaging reports of 70 patients were reviewed by a blinded musculoskeletal radiologist and compared with the respective arthroscopic fi ndings recorded in the operative notes. Pre-operative magnetic resonance imaging demonstrated a sensitivity level of 92.7% and 61.3% and specifi city level of 33.3% and 53.9% in detecting pathologies of the medial and lateral menisci, respectively. With respect to the cases of complete anterior cruciate ligament tear, sensitivity was 76.7% with 92.5% specifi city. On the other hand, magnetic resonance imaging demonstrated 100% sensitivity and 90.7% specifi city in the diagnosis of posterior cruciate ligament partial tear. Relatively better sensitivity in detecting cruciate ligaments pathology and better specifi city in detecting menisci pathology was reported using magnetic resonance imaging. Almost 25% of complete anterior cruciate ligament injuries may remain undetected in preoperative magnetic resonance imaging reports, while they represent the most prevalent knee injury. Magnetic resonance imaging should be used with caution in knee pathology and arthroscopy continues to be the gold standard.

scholarly journals Three-Dimensional Magnetic Resonance Imaging for Guiding Tibial and Femoral Tunnel Position in Anterior Cruciate Ligament Reconstruction: A Cadaveric Study

2020 ◽  
Vol 8 (3) ◽  
pp. 232596712090991
Author(s):  
Yousef Marwan ◽  
Jens Böttcher ◽  
Carl Laverdière ◽  
Rehana Jaffer ◽  
Mark Burman ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
3D Mri ◽  
Tunnel Position ◽  
Median Distance ◽  
Anterior Cruciate ◽  
Mri Measurements

Background: Femoral and tibial tunnel malposition for anterior cruciate ligament (ACL) reconstruction (ACLR) is correlated with higher failure rate. Regardless of the surgical technique used to create ACL tunnels, significant mismatches between the native and reconstructed footprints exist. Purpose: To compare the position of tunnels created by a standard technique with the ones created based on preoperative 3-dimensional magnetic resonance imaging (3D MRI) measurements of the ACL anatomic footprint. Study Design: Controlled laboratory study. Methods: Using 3D MRI, the native ACL footprints were identified. Tunnels were created on 16 knees (8 cadavers) arthroscopically. On one knee of a matched pair, the tunnels were created based on 3D MRI measurements that were provided to the surgeon (roadmapped technique), while on the contralateral knee, the tunnels were created based on a standard anatomic ACLR technique. The technique was randomly assigned per set of knees. Postoperatively, the positions of the tunnels were measured using 3D MRI. Results: On the tibial side, the median distance between the center of the native and reconstructed ACL footprints in relation to the root of the anterior horn of the lateral meniscus medially was 1.7 ± 2.2 mm and 1.9 ± 2.8 mm for the standard and roadmapped techniques, respectively ( P = .442), while the median anteroposterior distance was 3.4 ± 2.4 mm and 2.5 ± 2.5 mm for the standard and roadmapped techniques, respectively ( P = .161). On the femoral side, the median distance in relation to the apex of the deep cartilage (ADC) distally was 0.9 ± 2.8 mm and 1.3 ± 2.1 mm for the standard and roadmapped techniques, respectively ( P = .195), while the median distance anteriorly from the ADC was 1.2 ± 1.3 mm and 4.6 ± 4.5 mm for the standard and roadmapped techniques, respectively ( P = .007). Conclusion: Providing precise radiological measurements of the ACL footprints does not improve the surgeon’s ability to position the tunnels. Future studies should continue to attempt to provide tools to improve the tunnel position in ACLR. Clinical Relevance: This cadaveric study indicates that despite the use of 3D MRI in understanding the ACL anatomy, re-creating the native ACL footprints remains a challenge.

scholarly journals Assessment of Anterior Cruciate Ligament Graft Maturity With Conventional Magnetic Resonance Imaging: A Systematic Literature Review

2019 ◽  
Vol 7 (6) ◽  
pp. 232596711984901 ◽  
Author(s):  
Pieter Van Dyck ◽  
Katja Zazulia ◽  
Céline Smekens ◽  
Christiaan H.W. Heusdens ◽  
Thomas Janssens ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Acl Graft ◽  
Conventional Mri ◽  
Anterior Cruciate

Background: Magnetic resonance imaging (MRI) signal intensity (SI) measurements are being used increasingly in both clinical and research studies to assess the maturity of anterior cruciate ligament (ACL) grafts in humans. However, SI in conventional MRI with weighted images is a nonquantitative measure dependent on hardware and software. Purpose: To conduct a systematic review of studies that have used MRI SI as a proxy for ACL graft maturity and to identify potential confounding factors in assessing the ACL graft in conventional MRI studies. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was conducted by searching the MEDLINE/PubMed, Scopus, and Cochrane Library electronic databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify studies that examined the healing of the intra-articular portion of the ACL graft by assessing SI on MRIs. Results: A total of 34 studies were selected for inclusion in this systematic review. The MRI acquisition techniques and methods to evaluate the ACL graft SI differed greatly across the studies. No agreement was found regarding the time frames of SI changes in MRI reflecting normal healing of the ACL tendon graft, and the graft SI and clinical outcomes after ACL reconstruction were found to be poorly correlated. Conclusion: The MRI acquisition and evaluation methods used to assess ACL grafts are very heterogeneous, impeding comparisons of SI between successive scans and between independent studies. Therefore, quantitative MRI-based biomarkers of ACL graft healing are greatly needed to guide the appropriate time of returning to sports after ACL reconstruction.

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