Increased global posterior tibial slope is significantly associated with higher ACL graft signal intensity on 2-Year postoperative MRI after primary ACL reconstruction using hamstring tendon autografts

Abstract Background The healing and remodeling process of tendon grafts after anterior cruciate ligament (ACL) reconstruction (ACLR) has received significant attention. This study aims to identify preoperative factors associated with postoperative signal intensity of the ACL graft after primary ACLR...

Full description

Saved in:
Bibliographic Details
Main Authors: Zhi-yu Zhang, Le-jin Hong, Wen-bin Bai, Jia-yi Shao, Yi-tian Gao, Xiao-yue Fu, Jian-quan Wang, Cheng Wang
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12891-024-08032-6
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832595038989713408
author Zhi-yu Zhang
Le-jin Hong
Wen-bin Bai
Jia-yi Shao
Yi-tian Gao
Xiao-yue Fu
Jian-quan Wang
Cheng Wang
author_facet Zhi-yu Zhang
Le-jin Hong
Wen-bin Bai
Jia-yi Shao
Yi-tian Gao
Xiao-yue Fu
Jian-quan Wang
Cheng Wang
author_sort Zhi-yu Zhang
collection DOAJ
description Abstract Background The healing and remodeling process of tendon grafts after anterior cruciate ligament (ACL) reconstruction (ACLR) has received significant attention. This study aims to identify preoperative factors associated with postoperative signal intensity of the ACL graft after primary ACLR. Methods A total of 90 patients underwent primary ACLR using hamstring tendon autografts by the same senior surgeon between January 2013 and December 2020 were included. Patients were followed up and scheduled for a 2-year postoperative magnetic resonance imaging (MRI) scan at our institute. Concomitant injuries were confirmed by arthroscopy. Posterior tibial slope (PTS) and anterior tibial subluxation (ATS) were measured on preoperative MRI, whereas the normalized signal intensity of the ACL graft was evaluated on postoperative MRI and calculated as the ratio of the graft signal intensity to that of the patellar tendon. Multivariable linear regression models were performed to identify preoperative factors associated with the postoperative signal intensity of the ACL graft. Results Multivariable analyses showed that increased global PTS (GPTS) (P = 0.008) and concomitant articular cartilage injuries (P = 0.005) were associated with higher average signal intensity of the ACL graft on two-year postoperative MRI, while preoperative internal rotational tibial subluxation (IRTS) calculated as the difference between lateral ATS and medial ATS did not show a significant association. Specifically, an increased GPTS was significantly associated with higher signal intensity in the proximal section of the ACL graft (P = 0.005), whereas no significant associations were observed in the middle and distal sections. Conclusions Increased preoperative GPTS was significantly associated with higher signal intensity of the ACL graft on 2-year postoperative MRI after primary ACLR, suggesting that a steep preoperative tibial slope may contribute to a suboptimal ligamentization process in hamstring tendon autografts. Level of evidence Level III, retrospective cohort study.
format Article
id doaj-art-42e7a84331b74659b06f7a70b320cfa2
institution Kabale University
issn 1471-2474
language English
publishDate 2024-11-01
publisher BMC
record_format Article
series BMC Musculoskeletal Disorders
spelling doaj-art-42e7a84331b74659b06f7a70b320cfa22025-01-19T12:04:25ZengBMCBMC Musculoskeletal Disorders1471-24742024-11-012511910.1186/s12891-024-08032-6Increased global posterior tibial slope is significantly associated with higher ACL graft signal intensity on 2-Year postoperative MRI after primary ACL reconstruction using hamstring tendon autograftsZhi-yu Zhang0Le-jin Hong1Wen-bin Bai2Jia-yi Shao3Yi-tian Gao4Xiao-yue Fu5Jian-quan Wang6Cheng Wang7Department of Sports Medicine, Peking University Third HospitalDepartment of Orthopedics, Zhangpu HospitalDepartment of Sports Medicine, Peking University Third HospitalDepartment of Sports Medicine, Peking University Third HospitalDepartment of Sports Medicine, Peking University Third HospitalDepartment of Sports Medicine, Peking University Third HospitalDepartment of Sports Medicine, Peking University Third HospitalDepartment of Sports Medicine, Peking University Third HospitalAbstract Background The healing and remodeling process of tendon grafts after anterior cruciate ligament (ACL) reconstruction (ACLR) has received significant attention. This study aims to identify preoperative factors associated with postoperative signal intensity of the ACL graft after primary ACLR. Methods A total of 90 patients underwent primary ACLR using hamstring tendon autografts by the same senior surgeon between January 2013 and December 2020 were included. Patients were followed up and scheduled for a 2-year postoperative magnetic resonance imaging (MRI) scan at our institute. Concomitant injuries were confirmed by arthroscopy. Posterior tibial slope (PTS) and anterior tibial subluxation (ATS) were measured on preoperative MRI, whereas the normalized signal intensity of the ACL graft was evaluated on postoperative MRI and calculated as the ratio of the graft signal intensity to that of the patellar tendon. Multivariable linear regression models were performed to identify preoperative factors associated with the postoperative signal intensity of the ACL graft. Results Multivariable analyses showed that increased global PTS (GPTS) (P = 0.008) and concomitant articular cartilage injuries (P = 0.005) were associated with higher average signal intensity of the ACL graft on two-year postoperative MRI, while preoperative internal rotational tibial subluxation (IRTS) calculated as the difference between lateral ATS and medial ATS did not show a significant association. Specifically, an increased GPTS was significantly associated with higher signal intensity in the proximal section of the ACL graft (P = 0.005), whereas no significant associations were observed in the middle and distal sections. Conclusions Increased preoperative GPTS was significantly associated with higher signal intensity of the ACL graft on 2-year postoperative MRI after primary ACLR, suggesting that a steep preoperative tibial slope may contribute to a suboptimal ligamentization process in hamstring tendon autografts. Level of evidence Level III, retrospective cohort study.https://doi.org/10.1186/s12891-024-08032-6Anterior cruciate ligament reconstructionPosterior tibial slopeSignal intensityGraftMRISignal-to-noise quotient
spellingShingle Zhi-yu Zhang
Le-jin Hong
Wen-bin Bai
Jia-yi Shao
Yi-tian Gao
Xiao-yue Fu
Jian-quan Wang
Cheng Wang
Increased global posterior tibial slope is significantly associated with higher ACL graft signal intensity on 2-Year postoperative MRI after primary ACL reconstruction using hamstring tendon autografts
BMC Musculoskeletal Disorders
Anterior cruciate ligament reconstruction
Posterior tibial slope
Signal intensity
Graft
MRI
Signal-to-noise quotient
title Increased global posterior tibial slope is significantly associated with higher ACL graft signal intensity on 2-Year postoperative MRI after primary ACL reconstruction using hamstring tendon autografts
title_full Increased global posterior tibial slope is significantly associated with higher ACL graft signal intensity on 2-Year postoperative MRI after primary ACL reconstruction using hamstring tendon autografts
title_fullStr Increased global posterior tibial slope is significantly associated with higher ACL graft signal intensity on 2-Year postoperative MRI after primary ACL reconstruction using hamstring tendon autografts
title_full_unstemmed Increased global posterior tibial slope is significantly associated with higher ACL graft signal intensity on 2-Year postoperative MRI after primary ACL reconstruction using hamstring tendon autografts
title_short Increased global posterior tibial slope is significantly associated with higher ACL graft signal intensity on 2-Year postoperative MRI after primary ACL reconstruction using hamstring tendon autografts
title_sort increased global posterior tibial slope is significantly associated with higher acl graft signal intensity on 2 year postoperative mri after primary acl reconstruction using hamstring tendon autografts
topic Anterior cruciate ligament reconstruction
Posterior tibial slope
Signal intensity
Graft
MRI
Signal-to-noise quotient
url https://doi.org/10.1186/s12891-024-08032-6
work_keys_str_mv AT zhiyuzhang increasedglobalposteriortibialslopeissignificantlyassociatedwithhigheraclgraftsignalintensityon2yearpostoperativemriafterprimaryaclreconstructionusinghamstringtendonautografts
AT lejinhong increasedglobalposteriortibialslopeissignificantlyassociatedwithhigheraclgraftsignalintensityon2yearpostoperativemriafterprimaryaclreconstructionusinghamstringtendonautografts
AT wenbinbai increasedglobalposteriortibialslopeissignificantlyassociatedwithhigheraclgraftsignalintensityon2yearpostoperativemriafterprimaryaclreconstructionusinghamstringtendonautografts
AT jiayishao increasedglobalposteriortibialslopeissignificantlyassociatedwithhigheraclgraftsignalintensityon2yearpostoperativemriafterprimaryaclreconstructionusinghamstringtendonautografts
AT yitiangao increasedglobalposteriortibialslopeissignificantlyassociatedwithhigheraclgraftsignalintensityon2yearpostoperativemriafterprimaryaclreconstructionusinghamstringtendonautografts
AT xiaoyuefu increasedglobalposteriortibialslopeissignificantlyassociatedwithhigheraclgraftsignalintensityon2yearpostoperativemriafterprimaryaclreconstructionusinghamstringtendonautografts
AT jianquanwang increasedglobalposteriortibialslopeissignificantlyassociatedwithhigheraclgraftsignalintensityon2yearpostoperativemriafterprimaryaclreconstructionusinghamstringtendonautografts
AT chengwang increasedglobalposteriortibialslopeissignificantlyassociatedwithhigheraclgraftsignalintensityon2yearpostoperativemriafterprimaryaclreconstructionusinghamstringtendonautografts