MRI identifies five causes of complications from ACL reconstruction surgery

Researchers using MRI have identified five possible causes of patient complications from anterior cruciate ligament (ACL) reconstruction surgery.

The multicenter study performed at Emory University Hospital in Atlanta and Sahlgrenska-Molndal University Hospital in Gothenburg included 16 patients who demonstrated symptoms suggesting ACL reconstruction failure. They underwent MR imaging 3 weeks to 3 years following surgery to possibly determine the cause(s) of their complications.

“Persistent pain was the most consistent patient complaint. Others complained of instability, joint swelling and infection,” lead author Claude Pierre-Jerome, MD, said in a press release from the American Roentgen Ray Society.

The researchers identified five possible causes of reconstruction failure and patient complication:

graft “discontinuity” (a tear or impingement in the graft, 5 knees);
inappropriate position of the femoral and/or tibial tunnel (graft will not function properly without proper tunnel positioning, 2 knees);
hardware failure (screws may not be in the right position, 3 knees);
infection (1 knee); and
intra-articular arthrofibrosis (affecting movement of the joint, 4 knees).

“These are only preliminary results for a much larger study,” Pierre-Jerome said in the press release.

“ACL reconstructive surgery is very common. In fact, ACL injuries account for every one in 3,000 injuries. We see many patients with a history of ACL surgery, and it is our goal to make radiology more focused on the findings of pain in the knee,” he said.

Pierre-Jerome and his co-workers believe that “MRI can accurately detect the causes of surgical failure and persistent pain. MRI allows us to see all of the structures of the knee very well,” he said. “If the graft is not normal, we can make a note of it and tell the surgeon right away that something is wrong.”