Ces radiol. 2015, 69(4):278-284 | DOI: 10.55095/CesRadiol2015/041

Causes of dysfunction of the knee joint after anterior cruciate ligament reconstruction - diagnostic by magnetic resonance imagingOriginal article

Boris Pauček^1,2, David Smékal², Jaroslav Opavský², Radomír Holibka³, Jana Zapletalová⁴

¹ Pracoviště magnetické rezonance Medihope VN, Olomouc

² Katedra fyzioterapie FTK UP, Olomouc

³ Ortopedická klinika LF a FN, Olomouc

⁴ Ústav lékařské biofyziky LF UP, Olomouc

Aim: To characterize changes in the structures of the knee joint which contribute to the failure of the joint to function after the reconstruction of the anterior cruciate ligament.

Methods: In a group of 44 patients after surgery of the anterior cruciate ligament sent for MRI examination for problems in the knee joint that had been operated on, we evaluated the integrity of the ACL replacement and the occurrence of other structural changes in the joint. The group comprised 36 men (81.8%) and 8 women (18.2%). The median age of the patients was 31.0 years, the minimum age was 18 years and the maximum age was 52 years. The patients were examined with the HDxT Signa 1.5 T (GE Healthcare, Milwaukee, USA) using the HD 1.5T knee coil.

Results: In the group of 44 patients examined after ACL reconstruction, we diagnosed a failure of the ACL graft in 3 patients (6.8%). For other patients with a favorable course of the ACL graft, but with clinical problems in the knee joint, we demonstrated subsequent lesions that caused postoperative discomfort in the patients. These lesions include a meniscal lesion in 88.6%, increased synovial fluid in 75%, a bone edema in 45.5%, Hoffa's fat pad syndrome in 36.4%, filling of the Baker pseudocyst in 15.9%, a lesion of the lateral collateral ligament in 11.4% and a lesion of the posterior cruciate ligament in 6.8%. In 2 patients (4.5%) we examined a currently stable ACL graft that had been reoperated because of the failure of a previous graft.

Conclusion: The most common causes of dysfunction of the knee joint after ACL reconstruction, besides the failure of the ACL graft, include a meniscal lesion, an increase in the amount of synovial fluid, a bone edema, Hoffa's fat pad syndrome, filling of the Baker pseudocyst, a lesion of the lateral collateral ligament and a lesion of the posterior cruciate ligament. Diagnosis and accurate determination of the type of lesion of the knee joint are important for an orthopedic surgeon because of the determination of further conservative or surgical therapeutic procedures.

Keywords: graft anterior cruciate ligament reconstruction, knee joint, magnetic resonance, rupture of the anterior cruciate ligament replacement

Accepted: November 20, 2015; Published: December 1, 2015  Show citation