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3-T MR imaging of partial ACL tears: a cadaver study

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Magnetic resonance imaging (MRI) is the most commonly used diagnostic imaging procedure for suspected injuries to the anterior cruciate ligament (ACL). However, MRI has less utility for the evaluation of partial ACL tears. The goal of this study was to evaluate the possibility of distinguishing partial ACL tears applying the double bundle concept by dividing the ACL anatomy in the anteromedial (AM) and posterolateral bundle (PL). Six human cadaver knees were used in this laboratory study. The protocol consisted of sagittal, oblique coronal, and oblique sagittal proton-density-weighted fast spin echo sequences. After MRI the AM and the PL bundle were severed to mimic different partial ACL rupture patterns. MRI scanning of each knee was repeated, to record the quantitative parameters tilt and ACL angles and discontinuity as a nonquantitative parameter. Three orthopaedic surgeons and two radiologists were enlisted as blinded observers to evaluate the images. The transection patterns could be differentiated by evaluating discontinuity both in the paracoronal and in the sagittal plane. Evaluating the transection patterns, the AM bundle reached a better result in both planes compared to the PL bundle and the paracoronal plane had a better result in assessing the transection patterns compared to the sagittal plane for the PL bundle. Partial ACL transections could predictably be recognized on oblique sagittal and oblique coronal planes utilizing 3-T MRI technology. This concept allows a more precise description of ACL rupture patterns and might lead to a more distinctive approach for reconstructive surgery. The presurgical planning could be improved by applying a treatment algorithm based on a description of each bundle as intact or ruptured, leading to a reconstruction of the torn and a preservation of the intact bundle.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, Suite 1011, Pittsburgh, PA, 15213, USA

    Hanno Steckel, Gianluca Vadala, Volker Musahl & Freddie H. Fu

  2. Department of Orthopaedic Surgery, University of Göttingen, Robert-Koch-Straße 40, 37073, Göttingen, Germany

    Hanno Steckel

  3. Department of Orthopaedic Surgery, Campus Bio-Medico University, Via E. Longoni 69, 00155, Rome, Italy

    Gianluca Vadala

  4. Magnetic Resonance Research Center, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, 15213, USA

    Denise Davis

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  1. Hanno Steckel
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  2. Gianluca Vadala
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  3. Denise Davis
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  4. Volker Musahl
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  5. Freddie H. Fu
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Correspondence to Hanno Steckel.

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Steckel, H., Vadala, G., Davis, D. et al. 3-T MR imaging of partial ACL tears: a cadaver study. Knee Surg Sports Traumatol Arthr 15, 1066–1071 (2007). https://doi.org/10.1007/s00167-007-0337-5

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  • DOI: https://doi.org/10.1007/s00167-007-0337-5

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