Comparing clinical and functional outcomes of anterior cruciate ligament reconstruction using sonoelastografi

Injuries to the anterior cruciate ligament (ACL) are prevalent, particularly following athletic incidents. Most clinicians use MRI for diagnostic purposes and therapy assessment, but it can present challenges in terms of cost and accessibility. While ultrasound guidance (USG) is more readily available, it is inadequate for diagnosing ACL injury in isolation. Therefore, our study aimed to evaluate the effectiveness of sonoelastography, a novel method for assessing tendon injuries, in the context of anterior cruciate ligament (ACL) injuries.

This study involved a cohort of 45 patients who fulfilled the designated inclusion criteria. We selected the patients from a cohort of 105 individuals who underwent anatomical ACL restoration at the orthopedics and traumatology clinic between 2017 and 2020. The clinical examination results and the stability and quality of the ACL in patients who underwent ACL reconstruction were compared with those from magnetic resonance imaging (MRI) and stress echo laxity (SEL) testing.

The study comprised 40 individuals with a mean age of 30.7+-1.4 years. The patients' Lysholm scores exhibited consider-able enhancement post-operation, with a mean increase from 2.2+-0.9 pre-operation to 6.1+-1.6 post-operation. The Lachman, anterior drawer, and pivot-shift tests demonstrated improvements relative to the preoperative values. No substantial difference was observed in the single-leg hop test relative to the unaffected side. The SEL findings indicated that 15.6% of the healthy ACL instances were categorized as type 2a, 68.9% as type 2b, and 15.6% as type 3a. In the reconstructed ACL cohort, 17.8% were categorized as type 2a, 62.2% as type 2b, and 20% as type 3a. No substantial statistical difference was detected between the healthy ACL and the reconstructed ACL. No occurrences of type 3b or type 4 were identified in any of the patients.

We used SEL to find a torn ACL and check its stability and condition after the ligament was reconstructed with a graft. We utilize SEL, or stress sonoelastography, to monitor graft viability and evaluate the progression of ACL injuries. It is also beneficial in evaluating whether the restored ligament possesses a functional structure akin to that of a normal ligament. Moreover, considering its accessibility, cost-effectiveness, replicability, and patient preference, it may provide a more advantageous alternative to MRI.