Chronological changes in cross-sectional area of the bone-patellar tendon-bone autograft after anatomic rectangular tunnel ACL reconstruction.
ACL reconstruction (ACLR)
Anatomic rectangular tunnel (ART)
Bone-patellar tendon-bone (BTB) autografts
Cross-sectional area (CSA)
Magnetic resonance imaging (MRI)
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
21
07
2020
accepted:
07
12
2020
pubmed:
17
1
2021
medline:
16
10
2021
entrez:
16
1
2021
Statut:
ppublish
Résumé
The purpose of this study was to evaluate the change in cross-sectional area (CSA) of bone-patellar tendon-bone (BTB) autografts up to 5 years after the anatomic rectangular tunnel (ART) anterior cruciate ligament reconstruction (ACLR). The changing pattern in CSA might be a potential indicator of the graft remodeling process. Ninety-six (62 males, 34 females, mean age 27.0 years) patients were enrolled in this study with a total of 220 MRI scans after ART BTB ACLR to evaluate the CSA of the ACL autografts. The patients with first time unilateral ACLR that consented to undergo MRI evaluations at postoperative periods were included in this study. Intraoperatively, the CSA of the graft was measured directly using a custom-made area micrometer at the midpoint of the graft. Postoperatively, using an oblique axial slice MRI that was perpendicular to the long axis of the graft, the CSA of the graft was measured with digital radiology viewing program "SYNAPSE" at the midpoint of the graft. The postoperative MRI scans were classified into seven groups according to the period from ACLR to MRI evaluation: Group 0-2 months (m.), Group 3-6 m., Group 7-12 m., Group 1-2 years (y.), Group 2-3 y., Group 3-4 y., and Group 4 y.-. The percent increase of the CSA was calculated by dividing the postoperative CSA by the intraoperative CSA. The postoperative CSA was significantly larger than the intraoperative CSA in each group, with the exception of Group 0-2 m. The mean percent increase of the CSA in Group 0-2 m., 3-6 m., 7-12 m., 1-2 y., 2-3 y., 3-4 y., 4 y.- was 101.8 ± 18.2, 188.9 ± 27.4, 190.9 ± 43.7, 183.3 ± 28.9, 175.2 ± 27.9, 163.9 ± 19.8, 164.5 ± 25.4% respectively. The percent increase in Group 3-6 m., 7-12 m., 1-2 y., 2-3 y., 3-4 y., and 4 y.- was significantly greater than that in Group 0-2 m. The CSA of the BTB autografts after the ART BTB ACLR increases rapidly by 3-6 months after ACLR, reached a maximum value of 190% at around 1 year, decreases gradually after that, and reaches a plateau at around 3 years. The current study might help clinicians to estimate an individual BTB autograft's remodeling stages when considering returning patients to sports. IV.
Identifiants
pubmed: 33452577
doi: 10.1007/s00167-020-06404-8
pii: 10.1007/s00167-020-06404-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3782-3792Informations de copyright
© 2021. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
Références
Abe S, Kurosaka M, Iguchi T, Yoshiya S, Hirohata K (1993) Light and electron microscopic study of remodeling and maturation process in autogenous graft for anterior cruciate ligament reconstruction. Arthroscopy 9:394–405
pubmed: 8216570
doi: 10.1016/S0749-8063(05)80313-5
Amiel D, Kleiner JB, Roux RD, Harwood FL, Akeson WH (1986) The phenomenon of “ligamentization”: anterior cruciate ligament reconstruction with autogenous patellar tendon. J Orthop Res 4:162–172
pubmed: 3712125
doi: 10.1002/jor.1100040204
Arai Y, Hara K, Takahashi T, Urade H, Minami G, Takamiya H et al (2008) Evaluation of the vascular status of autogenous hamstring tendon grafts after anterior cruciate ligament reconstruction in humans using magnetic resonance angiography. Knee Surg Sports Traumatol Arthrosc 16:342–347
pubmed: 18193195
doi: 10.1007/s00167-007-0478-6
Arnoczky SP (1996) Biology of ACL reconstructions: what happens to the graft? Instr Course Lect 45:229–233
pubmed: 8727741
Arnoczky SP, Tarvin GB, Marshall JL (1982) Anterior cruciate ligament replacement using patellar tendon. An evaluation of graft revascularization in the dog. J Bone Jt Surg Am 64:217–224
doi: 10.2106/00004623-198264020-00011
Butler DL, Grood ES, Noyes FR, Olmstead ML, Hohn RB, Arnoczky SP et al (1989) Mechanical properties of primate vascularized vs. nonvascularized patellar tendon grafts; changes over time. J Orthop Res 7:68–79
pubmed: 2908914
doi: 10.1002/jor.1100070110
Butler DL, Grood ES, Noyes FR, Zernicke RF, Brackett K (1984) Effects of structure and strain measurement technique on the material properties of young human tendons and fascia. J Biomech 17:579–596
pubmed: 6490671
doi: 10.1016/0021-9290(84)90090-3
Claes S, Verdonk P, Forsyth R, Bellemans J (2011) The “ligamentization” process in anterior cruciate ligament reconstruction: what happens to the human graft? A systematic review of the literature. Am J Sports Med 39:2476–2483
pubmed: 21515806
doi: 10.1177/0363546511402662
Clancy WG Jr, Narechania RG, Rosenberg TD, Gmeiner JG, Wisnefske DD, Lange TA (1981) Anterior and posterior cruciate ligament reconstruction in rhesus monkeys. J Bone Jt Surg Am 63:1270–1284
doi: 10.2106/00004623-198163080-00008
Cohen J (1988) The analysis of variance. Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates, Hillsdale, pp 273–406
Falconiero RP, DiStefano VJ, Cook TM (1998) Revascularization and ligamentization of autogenous anterior cruciate ligament grafts in humans. Arthroscopy 14:197–205
pubmed: 9531133
doi: 10.1016/S0749-8063(98)70041-6
Fukuda H, Asai S, Kanisawa I, Takahashi T, Ogura T, Sakai H et al (2019) Inferior graft maturity in the PL bundle after autograft hamstring double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 27:491–497
pubmed: 30196436
doi: 10.1007/s00167-018-5087-z
Hadjicostas PT, Soucacos PN, Paessler HH, Koleganova N, Berger I (2007) Morphologic and histologic comparison between the patella and hamstring tendons grafts: a descriptive and anatomic study. Arthroscopy 23:751–756
pubmed: 17637411
doi: 10.1016/j.arthro.2007.02.002
Hamada M, Shino K, Horibe S, Mitsuoka T, Toritsuka Y, Nakamura N (2005) Changes in cross-sectional area of hamstring anterior cruciate ligament grafts as a function of time following transplantation. Arthroscopy 21:917–922
pubmed: 16084288
doi: 10.1016/j.arthro.2005.05.006
Hamada M, Shino K, Mitsuoka T, Abe N, Horibe S (1998) Cross-sectional area measurement of the semitendinosus tendon for anterior cruciate ligament reconstruction. Arthroscopy 14:696–701
pubmed: 9788365
doi: 10.1016/S0749-8063(98)70096-9
Hofbauer M, Soldati F, Szomolanyi P, Trattnig S, Bartolucci F, Fu F et al (2019) Hamstring tendon autografts do not show complete graft maturity 6 months postoperatively after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 27:130–136
pubmed: 30008057
doi: 10.1007/s00167-018-5033-0
Iriuchishima T, Shirakura K, Fu FH (2013) Graft impingement in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 21:664–670
pubmed: 22527419
doi: 10.1007/s00167-012-2014-6
Jackson DW, Grood ES, Goldstein JD, Rosen MA, Kurzweil PR, Cummings JF et al (1993) A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model. Am J Sports Med 21:176–185
pubmed: 8465909
doi: 10.1177/036354659302100203
Janssen RP, Scheffler SU (2014) Intra-articular remodelling of hamstring tendon grafts after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 22:2102–2108
pubmed: 23982759
doi: 10.1007/s00167-013-2634-5
Kinugasa K, Hamada M, Yoneda K, Matsuo T, Mae T, Shino K (2017) Cross-sectional area of hamstring tendon autograft after anatomic triple-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 25:1219–1226
pubmed: 26585909
doi: 10.1007/s00167-015-3880-5
Ma Y, Murawski CD, Rahnemai-Azar AA, Maldjian C, Lynch AD, Fu FH (2015) Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc 23:661–668
pubmed: 25223969
doi: 10.1007/s00167-014-3302-0
Mae T, Shino K, Matsumoto N, Yoneda K, Yoshikawa H, Nakata K (2014) Risk factors for ipsilateral graft rupture or contralateral anterior cruciate ligament tear after anatomic double-bundle reconstruction. Asia Pac J Sports Med Arthrosc Rehabil Technol 1:90–95
Mayr HO, Stoehr A, Dietrich M, von Eisenhart-Rothe R, Hube R, Senger S et al (2012) Graft-dependent differences in the ligamentization process of anterior cruciate ligament grafts in a sheep trial. Knee Surg Sports Traumatol Arthrosc 20:947–956
pubmed: 21953379
doi: 10.1007/s00167-011-1678-7
Min BH, Chung WY, Cho JH (2001) Magnetic resonance imaging of reconstructed anterior cruciate ligament. Clin Orthop Relat Res 393:237–243
doi: 10.1097/00003086-200112000-00026
Muramatsu K, Hachiya Y, Izawa H (2008) Serial evaluation of human anterior cruciate ligament grafts by contrast-enhanced magnetic resonance imaging: comparison of allografts and autografts. Arthroscopy 24:1038–1044
pubmed: 18760212
doi: 10.1016/j.arthro.2008.05.014
Ntoulia A, Papadopoulou F, Ristanis S, Argyropoulou M, Georgoulis AD (2011) Revascularization process of the bone–patellar tendon–bone autograft evaluated by contrast-enhanced magnetic resonance imaging 6 and 12 months after anterior cruciate ligament reconstruction. Am J Sports Med 39:1478–1486
pubmed: 21393641
doi: 10.1177/0363546511398039
Orsi AD, Canavan PK, Vaziri A, Goebel R, Kapasi OA, Nayeb-Hashemi H (2017) The effects of graft size and insertion site location during anterior cruciate ligament reconstruction on intercondylar notch impingement. Knee 24:525–535
pubmed: 28342722
doi: 10.1016/j.knee.2017.02.010
Pauzenberger L, Syré S, Schurz M (2013) “Ligamentization” in hamstring tendon grafts after anterior cruciate ligament reconstruction: a systematic review of the literature and a glimpse into the future. Arthroscopy 29:1712–1721
pubmed: 23859954
doi: 10.1016/j.arthro.2013.05.009
Rodeo SA, Arnoczky SP, Torzilli PA, Hidaka C, Warren RF (1993) Tendon-healing in a bone tunnel. A biomechanical and histological study in the dog. J Bone Jt Surg Am 75:1795–1803
doi: 10.2106/00004623-199312000-00009
Rougraff B, Shelbourne KD, Gerth PK, Warner J (1993) Arthroscopic and histologic analysis of human patellar tendon autografts used for anterior cruciate ligament reconstruction. Am J Sports Med 21:277–284
pubmed: 8465925
doi: 10.1177/036354659302100219
Sánchez M, Anitua E, Azofra J, Prado R, Muruzabal F, Andia I (2010) Ligamentization of tendon grafts treated with an endogenous preparation rich in growth factors: gross morphology and histology. Arthroscopy 26:470–480
pubmed: 20362825
doi: 10.1016/j.arthro.2009.08.019
Schützenberger S, Grabner S, Schallmayer D, Kontic D, Keller F, Fialka C (2020) The risk of graft impingement still exists in modern ACL surgery and correlates with degenerative MRI signal changes. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-06300-1
doi: 10.1007/s00167-020-06300-1
pubmed: 33009942
Shimizu K, Yoshiya S, Kurosaka M, Sugihara T, Beppu M, Aoki H (2007) Change in the cross-sectional area of a patellar tendon graft after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 15:515–521
pubmed: 17031612
doi: 10.1007/s00167-006-0206-7
Shino K, Kawasaki T, Hirose H, Gotoh I, Inoue M, Ono K (1984) Replacement of the anterior cruciate ligament by an allogeneic tendon graft. An experimental study in the dog. J Bone Jt Surg Br 66:672–681
doi: 10.1302/0301-620X.66B5.6501359
Shino K, Mae T, Tachibana Y (2015) Anatomic ACL reconstruction: rectangular tunnel/bone-patellar tendon-bone or triple-bundle/semitendinosus tendon grafting. J Orthop Sci 20:457–468
pubmed: 25753837
pmcid: 4518079
doi: 10.1007/s00776-015-0705-9
Shino K, Nakata K, Nakamura N, Toritsuka Y, Horibe S, Nakagawa S et al (2008) Rectangular tunnel double-bundle anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft to mimic natural fiber arrangement. Arthroscopy 24:1178–1183
pubmed: 19028171
doi: 10.1016/j.arthro.2008.06.010
Shino K, Nakata K, Nakamura N, Toritsuka Y, Nakagawa S, Horibe S (2005) Anatomically oriented anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft via rectangular socket and tunnel: a snug-fit and impingement-free grafting technique. Arthroscopy 21:1402
pubmed: 16325099
doi: 10.1016/j.arthro.2005.08.017
Tanaka Y, Yonetani Y, Shiozaki Y, Kitaguchi T, Sato N, Takeshita S et al (2010) Retear of anterior cruciate ligament grafts in female basketball players: a case series. Sports Med Arthrosc Rehabil Ther Technol 2:7
pubmed: 20214783
pmcid: 2845120
Tomita F, Yasuda K, Mikami S, Sakai T, Yamazaki S, Tohyama H (2001) Comparisons of intraosseous graft healing between the doubled flexor tendon graft and the bone-patellar tendon-bone graft in anterior cruciate ligament reconstruction. Arthroscopy 17:461–476
pubmed: 11337712
doi: 10.1053/jars.2001.24059
Toritsuka Y, Horibe S, Mitsuoka T, Nakamura N, Hamada M, Shino K (2003) Comparison between the cross-sectional area of bone-patellar tendon-bone grafts and multistranded hamstring tendon grafts obtained from the same patients. Knee Surg Sports Traumatol Arthrosc 11:81–84
pubmed: 12664199
doi: 10.1007/s00167-003-0349-8
van Groningen B, van der Steen MC, Janssen DM, van Rhijn LW, van der Linden AN, Janssen RPA (2020) Assessment of graft maturity after anterior cruciate ligament reconstruction using autografts: a systematic review of biopsy and magnetic resonance imaging studies. Arthrosc Sports Med Rehabil 2:e377–e388
pubmed: 32875303
pmcid: 7451875
doi: 10.1016/j.asmr.2020.02.008
Warth RJ, Zandiyeh P, Rao M, Gabr RE, Tashman S, Kumaravel M et al (2020) Quantitative assessment of in vivo human anterior cruciate ligament autograft remodeling: a 3-dimensional UTE-T2* imaging study. Am J Sports Med 48:2939–2947
pubmed: 32915640
doi: 10.1177/0363546520949855
Weiler A, Peters G, Maurer J, Unterhauser FN, Sudkamp NP (2001) Biomechanical properties and vascularity of an anterior cruciate ligament graft can be predicted by contrast-enhanced magnetic resonance imaging. A 2-year study in sheep. Am J Sports Med 29:751–761
pubmed: 11734489
doi: 10.1177/03635465010290061401
Yoshiya S, Nagano M, Kurosaka M, Muratsu H, Mizuno K (2000) Graft healing in the bone tunnel in anterior cruciate ligament reconstruction. Clin Orthop Relat Res 376:278–286
doi: 10.1097/00003086-200007000-00036
Zaffagnini S, De Pasquale V, Marchesini Reggiani L, Russo A, Agati P, Bacchelli B et al (2007) Neoligamentization process of BTPB used for ACL graft: histological evaluation from 6 months to 10 years. Knee 14:87–93
pubmed: 17188877
doi: 10.1016/j.knee.2006.11.006