Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Ön Çapraz Bağ Greft Rekonstrüksiyonu ve Tekrarlayan Potansiyel Rüptür Komplikasyonlarının Manyetik Rezonans Görüntüleme Bulguları: Tanımlayıcı Araştırma
Magnetic Resonance Imaging Findings in Anterior Cruciate Ligament Graft Reconstruction and Evaluation of Potential Recurrent Rupture Complication: Descriptive Study
Hakan BAHADIRa , Enise Yağmur ÖZKANb
aBetatom Emar, İstanbul, Türkiye
bİstanbul Üniversitesi-Cerrahpaşa Cerrahpaşa Tıp Fakültesi, Radyoloji ABD, İstanbul, Türkiye
Turkiye Klinikleri J Med Sci. 2024;44(1):27-34
doi: 10.5336/medsci.2023-100294
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmada, ön çapraz bağ (ÖÇB) rekonstrüksiyon cerrahisi geçirmiş bir grup vakada, normal greft rekonstrüksiyonlarının manyetik rezonans görüntüleme (MRG) bulgularını tanımlanması ve rekonstrüksiyon sonrası en sık karşılaşılan potansiyel komplikasyonların tanısında MRG'nin rolünün ortaya konulması amaçlanmıştır. Gereç ve Yöntemler: ÖÇB rekonstrüksiyon cerrahisi geçirmiş olan 16 olgu çalışmaya dâhil edildi. Retrospektif ve tek merkezli olan çalışma örneklemini tıbbi görüntüleme merkezimize başvuran ve ÖÇB rekonstrüktif cerrahisini takiben MRG ile tetkik edilmiş olgular oluşturmaktadır. Hastaların MRG bulguları, ÖÇB greft bütünlüğü ve eşlik eden diğer komplikasyonlar açısından retrospektif olarak değerlendirildi. Bulgular: On hastada sol (%62,5), 6 hastada ise sağ (%37,5) ÖÇB rüptürüne yönelik rekonstrüksiyon gerçekleştirilmiştir. ÖÇB rekonstrüksiyon cerrahisi geçirmiş 16 olgunun 6'sında ÖÇB konturu ayırt edilememiş, bu hastalardan 5'inde komplet ÖÇB greft yırtığı (rekürren yırtık), 1 tanesinde ise parsiyel ÖÇB greft yırtığı görülmüştür. Olguların 1 tanesinde avulsiyon fraktürü, 3 olguda meniskal dejenerasyon ve 7 olguda meniskal yırtık görülmüştür. Bir olguda mediyal menisküs posterior hornunda totale yakın rüptür, 1 olguda kova sapı yırtığı, 1 olguda intraligamentöz yırtık, 2 olguda greft impingement tespit edilmiştir. 16 olgunun 13'ünde ise eşlik eden minör patolojiler (9 intrakapsüler efüzyon, 4 intraartiküler sinoviyal efüzyon) saptanmıştır. Sonuç: Çalışmada ortaya konulan bulgular MRG'nin, ÖÇB greft rekonstrüksiyonunun, tünellerin ve fiksasyon materyallerinin pozisyonunu değerlendirmede, operasyon sonrası ağrı ve fonksiyon kaybının nedenini araştırmada kullanılabilen etkili bir görüntüleme yöntemi olduğunu desteklemektedir.

Anahtar Kelimeler: Ön çapraz bağ; ön çapraz bağ rekonstrüksiyonu; manyetik rezonans görüntüleme
ABSTRACT
 Objective: The aim of this study was to describe the magnetic resonance imaging (MRI) findings of normal graft reconstructions in a group of patients who underwent anterior cruciate ligament (ACL) reconstruction surgery and to demonstrate the role of MRI in the diagnosis of the most common potential complications after reconstruction. Material and Methods: Sixteen patients who underwent ACL reconstruction surgery were included in the study. The retrospective and single-center study sample consisted of patients who applied to our medical imaging center and were examined with MRI following ACL reconstructive surgery. The MRI findings of the patients were retrospectively evaluated for ACL graft integrity and other associated complications. Results: Ten patients underwent reconstruction for left (62.5%) and 6 patients for right (37.5%) ACL rupture. Discontinuity of the ligament or abnormal contour was detected in 6 of 16 patients who underwent ACL reconstruction surgery. Five of these patients had complete ACL graft tear (recurrent tear) and 1 patient had partial ACL graft tear. Avulsion fracture was seen in 1 case, meniscal degeneration in 3 cases and meniscal tear in 7 cases. In 1 case near total rupture of the posterior horn of the medial meniscus, in 1 case bucket handle tear, in 1 case intraligamantous tear and in 2 cases graft impingement were detected. In 13 of 16 cases, accompanying minor pathologies (9 intracapsular effusions, 4 intra-articular synovial effusions, 4 intra-articular) were observed. Conclusion: The findings of this study support that MRI is an important modality for assessing graft integrity, position of tunnels and fixation materials in ACL reconstruction. It is also an efficient imaging modality to investigate the cause of postoperative pain and loss of function.

Keywords: Anterior cruciate ligament; anterior cruciate ligament reconstruction; magnetic resonance imaging
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