Joseph Christian Giaconi MD, Presenter: Nothing to Disclose

William Tan, Abstract Co-Author: Nothing to Disclose

Christina Allen MD, Abstract Co-Author: Nothing to Disclose

To identify which postoperative radiographic parameters significantly differ in a single cohort of patients with failed or intact ACL grafts.

Fifty patients who underwent prior ACL reconstruction presented for clinical and radiographic evaluations. Twenty-four had clinically unstable knees (positive Lachman/pivot shift) and underwent ACL revision. Twenty-six had stable knees (negative Lachman/pivot shift) and underwent arthroscopy for other reasons (meniscus, articular cartilage, synovitis). All surgeries were performed by a single surgeon who performed all clinical and arthroscopic evaluations. X-ray and magnetic resonance imaging (MRI) measurements were performed on a radiographic websystem and included anterior tibial translation, tibial/femoral tunnel sagittal position, tibial tunnel coronal position, tibial/femoral tunnel orientation, and femoral tunnel back wall position.

Anterior tibial translation was not significantly different between the failed and intact groups. No significant differences were found in regards to tibial or femoral tunnel positions. X-ray evaluations showed femoral tunnel back wall position was significantly greater in the failed group (4.35 vs. 2.29mm)(p=0.0207). Femoral tunnel orientation (beta angle) was found to be significantly greater in the intact group according to MRI readings (20.90 vs. 25.62degrees)(p=0.0167).

There are statistically significant differences in femoral tunnel back wall position and femoral tunnel orientation between failed and intact ACL reconstructions.  

Clinical relevance is to determine clinically significant findings in evaluation of ACL graft reconstructions.  

Giaconi, J, Tan, W, Allen, C, Femoral Tunnel Position and Orientation Predict Failure of Grafts in ACL Reconstruction.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12029415.html