Postoperative radiological evaluation of anterior cruciate ligament reconstruction and its complications

Method: In a comparative study in which patients were admitted and operated at Medical college & tertiary care hospital from January 2016 onwards. All patients who presented with symptoms after the surgery and whose data is available with the patients are considered. Plain radiograph which was taken after the surgery immediate postop, 2 weeks, 6 weeks and 3 months as routine follow-up, were documented for radiological evaluation.MR imaging which was done postoperatively during follow-up, was also documented for evaluation.

Result: Pain was the most common symptom (52%) followed by swelling (40%) and restricted movements (28%). There was significant widening of femoral and tibial diameter on plain radiograph in both the views anteroposterior and lateral during follow up period which started 2 weeks after surgery. There was increase in signal intensity in MR images for almost all the cases (92%). Femoral tunnel placement was perfect in 88 percent cases while tibial tunnel placement was perfect in 76 percent cases.

Conclusion: It can be concluded from the study that tunnel widening was unrelated to the postop complication as it was seen in all cases and Plain radiograph is a reliable measure to compare the tunnel widening on serial films as the results shows comparable data. There was increased graft intensity on MR images in maximum cases and this parameter is also unrelated to the complication. Tibial tunnel position is more important than femoral tunnel to prevent impingement as patient presented with restricted movements were having abnormal placement of tibial tunnel. Sterility is an important factor for surgical outcome as one of the patient developed septic like features after the surgery.