Prospective MRI-Based Comparison of Graft Maturation After ACL Reconstruction Using Quadriceps Versus Hamstring...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Radiology

Background:

• Graft maturation after ACL reconstruction is prolonged and varies, not always correlating with clinical recovery.
• Magnetic resonance imaging (MRI)-based signal intensity ratio (SIR) is a common indirect marker for graft remodeling.
• Limited comparative data exists on MRI-assessed graft maturation between quadriceps tendon (QT) and hamstring tendon (HT) autografts.

Purpose of the Study:

• To compare graft maturation between all-soft tissue QT and HT autografts.
• Utilize quantitative MRI-based SIR at 6 and 12 months post-ACL reconstruction.
• Evaluate maturation in athletes undergoing primary all-inside ACL reconstruction.

Main Methods:

• Prospective cohort study of 76 athletes (39 QT, 37 HT) undergoing primary all-inside ACL reconstruction.
• Standardized rehabilitation protocol and 3.0-T MRI at 6 and 12 months.
• Graft maturation assessed via SIR, with posterior cruciate ligament as reference; interobserver reliability evaluated.

Main Results:

• No significant differences in mean SIR values between QT and HT autografts at 6 and 12 months.
• Both groups showed significant SIR decrease from 6 to 12 months, indicating progressive maturation.
• No difference in the magnitude of SIR change between graft types; excellent interobserver reliability (ICC=0.98).

Conclusions:

• Quantitative MRI (SIR) shows no significant difference in graft maturation between QT and HT autografts at 6 and 12 months post-ACL reconstruction.
• Both graft types exhibit comparable early postoperative maturation profiles on MRI.
• QT autografts are a reliable alternative to HT autografts in athletic populations undergoing ACL reconstruction.