TY - JOUR
T1 - Diffusion tensor imaging of the anterior cruciate ligament following primary repair with internal bracing
T2 - A longitudinal study
AU - Van Dyck, Pieter
AU - Froeling, Martijn
AU - Heusdens, Christiaan H W
AU - Sijbers, Jan
AU - Ribbens, Annemie
AU - Billiet, Thibo
N1 - Funding Information:
This work was supported by the research foundation FWO-Vlaanderen, Belgium (grant numbers 1831217N and T001017N to PVD and CHW, respectively). The funders had no role in the design, implementation, or analysis of this research. AR and TB are employees of Icometrix, Leuven, Belgium. Other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Funding Information:
This work was supported by the research foundation FWO‐Vlaanderen, Belgium (grant numbers 1831217N and T001017N to PVD and CHW, respectively). The funders had no role in the design, implementation, or analysis of this research. AR and TB are employees of Icometrix, Leuven, Belgium. Other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Publisher Copyright:
© 2020 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
PY - 2021/6
Y1 - 2021/6
N2 - Diffusion tensor imaging (DTI) provides information about tissue microstructure and its degree of organization by quantifying water diffusion. We aimed to monitor longitudinal changes in DTI parameters (fractional isotropy, FA; mean diffusivity, MD; axial diffusivity, AD; radial diffusivity, RD) of the anterior cruciate ligament (ACL) following primary repair with internal bracing (IBLA). Fourteen patients undergoing IBLA were enrolled prospectively and scheduled for clinical follow-up, including instrumented laxity testing, and DTI at 3, 6, 12, and 24 months postoperatively. DTI was also performed in seven healthy subjects. Fiber tractography was used for 3D segmentation of the whole ACL volume, from which median DTI parameters were calculated. The posterior cruciate ligament (PCL) served as a control. Longitudinal DTI changes were assessed using a linear mixed model, and repeated measures correlations were calculated between DTI parameters and clinical laxity tests. At follow-up, thirteen patients had a stable knee and one patient sustained an ACL rerupture after 12 months postoperatively. The ACL repair showed a significant decrease of FA within the first 12 months after surgery, followed by stable FA values thereafter, while ACL diffusivities decreased over time returning towards normal values at 24 months postoperatively. For PCL there were no significant DTI changes over time. There was a significant correlation between ACL FA and laxity tests (r = -0.42, P = .017). This study has shown the potential of DTI to longitudinally monitor diffusion changes in the ACL following IBLA. The DTI findings suggest that healing of the ACL repair is incomplete at 24 months postoperatively.
AB - Diffusion tensor imaging (DTI) provides information about tissue microstructure and its degree of organization by quantifying water diffusion. We aimed to monitor longitudinal changes in DTI parameters (fractional isotropy, FA; mean diffusivity, MD; axial diffusivity, AD; radial diffusivity, RD) of the anterior cruciate ligament (ACL) following primary repair with internal bracing (IBLA). Fourteen patients undergoing IBLA were enrolled prospectively and scheduled for clinical follow-up, including instrumented laxity testing, and DTI at 3, 6, 12, and 24 months postoperatively. DTI was also performed in seven healthy subjects. Fiber tractography was used for 3D segmentation of the whole ACL volume, from which median DTI parameters were calculated. The posterior cruciate ligament (PCL) served as a control. Longitudinal DTI changes were assessed using a linear mixed model, and repeated measures correlations were calculated between DTI parameters and clinical laxity tests. At follow-up, thirteen patients had a stable knee and one patient sustained an ACL rerupture after 12 months postoperatively. The ACL repair showed a significant decrease of FA within the first 12 months after surgery, followed by stable FA values thereafter, while ACL diffusivities decreased over time returning towards normal values at 24 months postoperatively. For PCL there were no significant DTI changes over time. There was a significant correlation between ACL FA and laxity tests (r = -0.42, P = .017). This study has shown the potential of DTI to longitudinally monitor diffusion changes in the ACL following IBLA. The DTI findings suggest that healing of the ACL repair is incomplete at 24 months postoperatively.
KW - anterior cruciate ligament repair
KW - diffusion magnetic resonance imaging
KW - knee injuries
UR - https://www.scopus.com/pages/publications/85083433422
U2 - 10.1002/jor.24684
DO - 10.1002/jor.24684
M3 - Article
C2 - 32270563
SN - 0736-0266
VL - 39
SP - 1318
EP - 1330
JO - Journal of Orthopaedic Research
JF - Journal of Orthopaedic Research
IS - 6
ER -