Magnetic resonance imaging of the quadriceps tendon autograft in anterior cruciate ligament reconstruction

Emerson, Christopher P.; Bernstein, Jeff; Nham, Fong; Barnhill, Spencer; Baraga, Michael G.; Bogner, Eric; Jose, Jean

doi:10.1007/s00256-019-03235-8

Cited by 6 publications

(6 citation statements)

References 61 publications

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“…A defect was defined as a depression deformity at the harvest site, while a scar tissue formation was defined as a change in iso‐ to high‐intensity signal at the harvested site on a fat suppression T2‐weighted images compared to the preoperative tendon (Fig. 4) [5].…”

Section: Methodsmentioning

confidence: 99%

Near complete quadriceps tendon healing 2 years following harvest in anterior cruciate ligament reconstruction

Inoue,

Dadoo,

Nukuto

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Despite the recent increase in the use of quadriceps tendon (QT) autograft in anterior cruciate ligament reconstruction (ACLR); however, there remains a paucity of literature evaluating the postoperative morphology of the QT. The present study aimed to determine the postoperative morphologic change of the QT at a minimum of 2 years following harvesting during ACLR. Methods Patients who underwent ACLR with QT autograft and underwent magnetic resonance imaging (MRI) at a minimum of 2 years following harvesting were retrospectively included in the study. The anterior-to-posterior (A-P) thickness, medial-to-lateral (M-L) width, cross-sectional area (CSA), and signal/noise quotient (SNQ) of the QT were assessed at 5 mm, 15 mm, and 30 mm proximal to the superior pole of the patella on MRI. The CSA was adjusted by the angle between the QT and the plane of the axial cut based on a cosine function (adjusted CSA). The A-P thickness, M-L width, adjusted CSA, and SNQ were compared pre-and postoperatively. In addition, defects or scar tissue formation in the harvest site were investigated on postoperative MRI. Results Thirty patients were recruited for the study. The mean duration between postoperative MRI and surgery was 2.8 ± 1.1 years. The mean A-P thickness was 10.3% and 11.9% larger postoperatively at 5 mm and 15 mm, respectively. The mean M-L width was 7.3% and 6.5% smaller postoperatively at 5 mm and 15 mm, respectively. There were no significant differences in the adjusted CSA between pre-and post-operative states (275.7 ± 71.6 mm 2 vs. 286.7 ± 91.8 mm 2 , n.s.). There was no significant difference in the postoperative change in the SNQ of the QT at all assessment locations. Defect or scar tissue formation at the harvest site was observed in 4 cases (13.3%), and 5 cases (16.6%), respectively. Conclusion At a minimum of 2 years following QT harvest during ACLR, the QT became slightly thicker and narrower (approximately 11% and 7%, respectively). While the current study demonstrates that QT re-harvesting can be considered due to nearly normalized tendon morphology, future histological and biomechanical studies are required to determine the re-harvesting potential of the QT. Level of evidence IV.

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Section: Methodsmentioning

confidence: 99%

Near complete quadriceps tendon healing 2 years following harvest in anterior cruciate ligament reconstruction

Inoue,

Dadoo,

Nukuto

et al. 2023

Knee surg. sports traumatol. arthrosc.

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“…Ideally, the tibial tunnel should be centered within the tibial footprint of the ACL, posteriorly where the Blumensaat line crosses the tibia plateau (►Fig. 4). Small amounts of fluid within the tunnels can be seen during approximately the first 18 months after ACL reconstruction.…”

Section: Optimal Positionmentioning

confidence: 99%

“…When a QT graft is used, rare postoperative complications are quadriceps tendon rupture, hematoma at the myotendinous junction of the rectus femoris (directly postoperative), or infection at the superior pole of the patella or patellar fracture. 4…”

Section: Donor Site Morbiditymentioning

confidence: 99%

“…3 The QT autograft is another emerging option for ACL reconstruction, with its own set of advantages. 4 The QT can be harvested as a partial-or full-thickness graft and with or without a bone block. 5 The biggest advantage is its minimal donor site morbidity, with less pain and easier ROM, especially during early rehabilitation, leading to a faster and less painful initial recovery for the patient.…”

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confidence: 99%

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Postoperative Magnetic Resonance Imaging after Anterior Cruciate Ligament Reconstruction: An Overview and Practical Step-by-step Guide

Doorschodt,

Smithuis,

Helmerhorst

et al. 2024

Semin Musculoskelet Radiol

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Anterior cruciate ligament (ACL) rupture is a frequently encountered injury among athletes, often requiring surgical intervention to restore knee stability. Magnetic resonance imaging (MRI) after ACL reconstruction is common, especially in the evaluation of clinical complications leading to knee instability, decreased range of motion, or pain. This article provides a detailed overview of normal and abnormal postoperative findings including a practical step-by-step guide for MRI assessment. MRI findings must be correlated with surgical technique, time interval from surgery to imaging, and clinical examination.

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“…It is important for radiologists to differentiate between hematoma sites, as postoperative hematoma from an ACL graft rupture typically occurs at the suprapatellar pouch and may dictate more immediate surgical intervention as compared with a hematoma caused by the LET. 17 …”

Section: Complications and Associated Imaging Findingsmentioning

confidence: 99%

Imaging Findings of Complications After Lateral Extra-Articular Tenodesis of the Knee: A Current Concepts Review

Marshall

Silva

Goldenberg

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Despite successful anterior cruciate ligament (ACL) reconstruction, many patients continue to experience persistent anterolateral rotatory instability. Lateral extra-articular tenodesis (LET) is used to address this instability by harvesting a portion of the iliotibial band, passing it underneath the fibular collateral ligament, and attaching it just proximal and posterior to the lateral femoral epicondyle. Based on the most recent clinical evidence, the addition of LET to ACL reconstruction improves clinical outcomes, which has led to an increase in the use of this technique. Purpose: To provide an overview of the postoperative complications of the LET procedure and their associated imaging findings, with a focus on magnetic resonance imaging (MRI). Study Design: Narrative review. Methods: In this scoping review, the authors reviewed available radiographic, computed tomography, and MRI scans of patients who experienced postoperative complications after ACL reconstruction with LET, in which the complication was determined to be from the LET procedure. Images were reviewed and subsequently described by an on-staff musculoskeletal radiologist. Results: The authors found 9 different complications associated with LET: graft failure, hematoma, infection, chronic pain, tunnel convergence, fixation device migration, muscular hernia, peroneal nerve palsy, and knee stiffness. They supplemented these findings with radiographic evidence from 6 patients. Conclusion: As extra-articular reconstruction techniques including LET become more popular among orthopaedic surgeons, it is important that radiologists and surgeons be adept at recognizing the normal imaging findings of LET and associated complications.

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Magnetic resonance imaging of the quadriceps tendon autograft in anterior cruciate ligament reconstruction

Cited by 6 publications

References 61 publications

Near complete quadriceps tendon healing 2 years following harvest in anterior cruciate ligament reconstruction

Near complete quadriceps tendon healing 2 years following harvest in anterior cruciate ligament reconstruction

Postoperative Magnetic Resonance Imaging after Anterior Cruciate Ligament Reconstruction: An Overview and Practical Step-by-step Guide

Imaging Findings of Complications After Lateral Extra-Articular Tenodesis of the Knee: A Current Concepts Review

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