ABSTRACT
To evaluate the usefulness of magnetic resonance imaging (MRI) in the exploration of the anterior cruciate ligament (ACL) deficient-knee, a total of twenty-five patients with chronic instability of the knee joint and who underwent both MRI and arthroscopy were studied prospectively. Twenty-three of these patients underwent an intra-articular reconstruction of the ACL with bone-patellar tendon-bone autografts. For the ACL lesions MRI had a sensitivity of 95.8%, a specificity of 100% and a diagnostic accuracy of 97.7%. Associated bowing of the PCL was seen in 20 cases of the study group. For the associated meniscal lesions MRI had a sensitivity of 77.7%, a specificity of 94.7% and a diagnostic accuracy of 91.5%. In no case did MRI allow to detect the minimal cartilage irregularities observed in the arthroscopy. MRI had great accuracy for the evaluation of the anchoring points, direction of the tunnels and the state of the autografts at intra-articular level. It is concluded that MRI is a useful imaging diagnostic modality for evaluation of the ACL deficient-knee and the intra-articular reconstruction of the ACL, thereby MRI affords the surgeon better preoperative planning.
Subject(s)
Anterior Cruciate Ligament Injuries , Anterior Cruciate Ligament/surgery , Joint Instability/diagnosis , Knee/pathology , Magnetic Resonance Imaging , Adult , Arthroscopy , Bone Transplantation , Female , Humans , Joint Instability/surgery , Male , Prospective Studies , Sensitivity and Specificity , Tendons/transplantation , Transplantation, AutologousABSTRACT
Repair of osteochondral defects in articular weightbearing areas presents its own particular problems because of the low potential of hyaline cartilage for regeneration. Our first group of experiments on the knee of the rabbit confirms that the new regenerated cartilage comes from bone marrow which degenerates before developing into true hyaline cartilage. The second group of experiments shows that autologous grafts from the non-weightbearing articular area suitable for the repair of defects in weightbearing areas. In an third group, autologous meniscal fibrocartilage was used as a graft for the repair of osteochondral defects.
