Morphologic evaluation of remnant anterior cruciate ligament bundles after injury with three-dimensional computed
Nobuo Adachi1, Mitsuo Ochi2, Kobun Takazawa2
1Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. nadachi@hiroshima-u.ac.jp.
Purpose:
This study aimed to investigate the morphological patterns of remnant anterior cruciate ligament bundles after injury (ACL remnant) on three-dimensional computed tomography (3DCT) and compare them with those on arthroscopy.
Methods:
Sixty-three patients (33 males and 30 females; mean age 25.2 ± 10.1 years) who had undergone primary ACL reconstruction between March 2011 and December 2012 were included in this study. The average durations between traumas and 3DCT and between 3DCT and surgery were 101.7 ± 87.2 and 38.2 ± 38.7 days, respectively. ACL remnants were classified into four morphological patterns on 3DCT. 3DCT findings were compared with arthroscopic findings with and without probing.
Results:
The morphological patterns of the ACL remnants on 3DCT were well matched with those on arthroscopy without probing (the concordance rate was 77.8%). However, the concordance rate was reduced to 49.2% when arthroscopic probing was used to confirm the femoral attachment of ACL remnants (p ≤ 0.05).
Conclusions:
This study demonstrates that the morphological patterns of ACL remnants on 3DCT were well matched with those on arthroscopy without probing. Therefore, the technique can be useful for preoperative planning of the ACL reconstruction or informed consent to the patients. However, for definitive diagnosis, arthroscopic probing is required.
Level Of Evidence:
IV.
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