Ön Çapraz Bağ Greft Rekonstrüksiyonunda Görüntüleme Bulguları

Öz

Amaç: Ön çapraz bağ ÖÇB greft rekonstrüksiyonunun postoperatif direkt grafi , manyetik rezonans görüntüleme MRG normal bulgularını tanımlamak, operasyon sonrası gelişebilecek potansiyel komplikasyonlarının MRG bulgularını sunmaktır.Gereç ve Yöntemler: Çalışmaya ÖÇB rekonstrüksiyon cerrahisi geçirmiş 52 hasta alındı. Hastaların direkt grafi , manyetik rezonans görüntüleri ÖÇB greft bütünlüğü ve eşlik edebilecek komplikasyonlar açısından retrospektif olarak değerlendirildi.Bulgular: Çalışmaya alınan 52 hastanın 18’inde postoperatif patolojik bulgular saptandı. Dört hastada total greft rüptürü, bir hastada parsiyel greft rüptürü, iki hastada gevşek greft, 10 hastada anterior yerleşimli tibial tünel, sekiz hastada tepe impigement, iki hastada yan duvar impigement, dört hastada tünelde kistik genişleme, bir hastada patellar fraktür, iki hastada operasyon materyaline bağlı iliotibial band sürtünme sendromu ve dört hastada artrofi brozis saptandı.Sonuç: MRG, ÖÇB greftinin, tünellerin ve fi ksasyon materyallerinin pozisyonunu değerlendirmede, operasyon sonrası ağrı ve fonksiyon kaybının nedenini araştırmada kullanılabilen etkili bir görüntüleme yöntemidir

Anahtar Kelimeler

• Ön çapraz bağ, Greft rekonstrüksiyonu, MR görüntüleme

Imaging of Anterior Cruciate Ligament Graft Reconstruction Imaging of Anterior Cruciate Ligament Graft Reconstruction

Abstract

Objective: The purpose of this study was to describe the postoperative X-Ray and magnetic resonance imaging MRI appearance of normal anterior cruciate ligament ACL graft reconstructions and to demonstrate most common potential complications.Material and Methods: Fifty-two patients with ACL reconstruction were included in the study. The X-Ray and MRI scans were reviewed retrospectively for the assessment of integrity of the reconstructed ligament and the presence of related complications.Results: Pathologic fi ndings were observed in 18 of 52 ACL reconstruction operations; Four total ACL graft ruptures and one partial rupture, two loosening grafts, 10 anteriorly localized tibial tunnels, eight roof impingements, two side wall impingements, four cystic tunnel dilatations, one patellar fracture, two iliotibial band friction syndromes because of hardware related complications, and four arthrofi brosis cases were observed.Conclusion: MRI is an effective imaging technique for evaluating the position of ACL grafts, tunnels and fi xation materials and for investigating the cause of pain and loss of function

Keywords

• Anterior Cruciate Ligament, Graft reconstruction, MR imaging

Kaynakça

1. White LM, Kramer J, Recht MP. MR imaging evaluation of the postoperative knee: ligaments, menisci, and articular cartilage. Skeletal Radiol 2005;34:431–52.
2. Bencardino JT, Beltran J, Feldman MI, Rose DJ. MR imaging of complications of anterior cruciate ligament graft reconstruction. RadioGraphics 2009;29:2115–26.
3. Beynnon BD, Uh BS, Johnson RJ, Abate JA, Nichols CE, Fleming BC, Poole AR, Roos H. Rehabilitation after anterior cruciate ligament reconstruction: A prospective, randomized, double-blind comparison of programs administered over 2 different time intervals. Am J Sports Med 2005;33:347–59.
4. Saupe N, White LM, Chiavaras MM, Essue J, Weller I, Kunz M, Hurtig M, Marks P. Anterior cruciate ligament reconstruction grafts: MR Imaging features at long-term follow-up—correlation with functional and Clinical Evaluation. Radiology 2008; 249(2):581-90.
5. Meyers AB, Haims AH, Menn K, Moukaddam H. Hicham moukaddam, imaging of anterior cruciate ligament repair and its complications, AJR 2010; 194:476–84.
6. Papakonstantinou O, Chung CB, Chanchairujira K, Resnick DL.Complications of anterior cruciate ligament reconstruction: MR imaging. Eur Radiol 2003;13:1106– 17.
7. Fineberg MS, Zarins B, Sherman OH. Practical considerations in anterior cruciate ligament replacement surgery. Arthroscopy 2000;16:715–24.
8. Collins MS, Unruh KP, Bond JR, Mandrekar JN. Magnetic resonance imaging of surgically confi rmed anterior cruciate ligament graft disruption. Skeletal Radiol 2008;37:233–43.

9. Rispoli DM, Sanders TM, Miller MD, Morrison WB. Magnetic resonance imaging at different time periods following hamstring harvest for anterior cruciate ligament reconstruction. Arthroscopy 2001;17:2–8.
10. Howell SM, Clark JA. Tibial tunnel placement in anterior cruciate ligament reconstructions and graft impingement. Clin Orthop Relat Res 1992; 283:187–95.
11. Bradley DM, Bergman AG, Dillingham MF. MR imaging of cyclops lesions. AJR Am J Roentgenol 2000;174:719– 26.
12. Sanders TG, Tall MA, Mulloy JP, Leis HT. Fluid collections in the osseous tunnel during the fi rst year after anterior cruciate ligament repair using an autologous hamstring graft: Natural history and clinical correlation. J Comput Assist Tomogr 2002;26:617–21
13. Deie M, Sumen Y, Ochi M, Murakami Y, Fujimoto E, Ikuta Y. Pretibial cyst formation after anterior cruciate ligament reconstruction using auto hamstring grafts: Two case reports in a prospective study of 89 cases. Magn Reson Imaging 2000;18: 973–77.
14. Pelfort X, Monllau JC, Puig L, Cáceres E. Iliotibial band friction syndrome after anterior cruciate ligament reconstruction using the transfi x device: report of two cases and review of the literature. Knee Surg Sports Traumatol Arthrosc 2006;14:586–9.
15. Bush-Joseph CA, Bach BR. Migration of femoral interference screw after anterior cruciate ligament reconstruction. Am J Knee Surg 1998;11:32–4.
16. Schollin-Borg M, Michaelsson K, Rahme H. Presentation, outcome and cause of septic arthritis after anterior cruciate ligament reconstruction: A case control study. Arthroscopy 2003;19:941–7