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An evaluation of reconstructed ACL impingement on PCL using MRI.

Nishimori M, Sumen Y, Sakaridani K, Nakamura M

Department of Orthopedic Surgery, JA Onomichi General Hospital, 7-19 Kohama-cho, Onomichi, Hiroshima 722-8508, Japan. mako7119@yahoo.co.jp

Using magnetic resonance imaging (MRI), we evaluated 42 reconstructed anterior cruciate ligaments (ACLs) for impingement on corresponding posterior cruciate ligaments (PCLs) in the knee-extended position. Thirty-one single-bundle ACL reconstructions and 11 double-bundle ACL reconstructions were performed. MR examinations were performed at 3 and 12 months after arthroscopic ACL reconstructions. Using oblique axial MRIs of reconstructed ACLs, we evaluated the shape of the PCL and divided them into two groups: an impingement-positive group and an impingement-negative group. Using sagittal images, we measured the PCL index (Liu's method) and examined the correlation between the degree of impingement and the index. At 3 months after surgery, 14 of 31 single-bundle ACL reconstructions and 5 of 11 double-bundle ACL reconstructions were regarded as positive impingement on PCLs. At 12 months after surgery, 17 of 31 single-bundle ACL reconstructions and 5 of 11 double-bundle ACL reconstructions were regarded as positive impingement on PCLs. At 3 months in single-bundle reconstructions and at 3 and 12 months in all reconstructions, the PCL index of the impingement-positive group was significantly lower than that of the negative group. This study indicated that reconstructed ACLs in the impingement-positive group pressed the PCLs more posteriorly than did the impingement-negative group.

Published 1 June 2007 in Magn Reson Imaging, 25(5): 722-6.
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