الفهرس 
Introduction & Aim of the workOnly 14 pages are availabe for public view
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Abstract
ACL is the most commonly reconstructed ligament in the knee. Clinical evaluation of ACL reconstructions is difficult, while MR imaging plays an important role in evaluating the integrity of the ACL graft, as well as in diagnosing complications associated with ACL reconstruction.
This study included 34 patients (32 males & 2 females) with their age ranged from 17 to 47 years with a mean age of 29 years. Patient complaints were knee pain, history of trauma, instability, limited extension, or palpable mass.
MRI study assessed the following items: the pattern of the ACL graft (discontinuity, SI, orientation), presence or absence of graft impingement, ganglion cyst, arthrofibrosis, and hardware malposition. Associated synovities, meniscal or ligamentous injuries were also evaluated.
Graft tear was the commonest finding (71%) in the included Cases. There were 24 patients with graft tear; 10(42%) had partial tear, 14(58 %) had complete tear. Four grafts from the completely torn grafts were not seen as they were resorbed. Graft SI was normal or grade II in some cases of complete tear, but increased to grade III or IV in the other complete tear cases and in all partial tear cases. There were significant positive correlation between graft SI and tear.
Regarding graft orientation, normal graft orientation was detected in all intact grafts except 2 (lax because of posterior tibial tunnel malposition). Grafts were seen lax in all Partial tear cases, and in 60% of the seen complete torn grafts. Horizontal orientation occurred only when the grafts were completely torn. The correlation between graft orientation and tear was positively significant.
The MRI study revealed graft complications in 20/34 knees (59%): graft impingement in 12 knees, Ganglion Cyst in 6 knees, cyclops in 4 knees, and hardware mal-position (loose femoral screw) in 2 knees.
The images of impingement cases showed increasing in the graft SI and lax orientation. All impinged grafts were being torn whether partially or complete. Their correlation with graft discontinuity was significant: positively when all grafts data were studied, and negatively when only torn grafts data were studied.
Regarding ganglion cyst cases, all grafts had increased SI and most of them were lax and partially torn. There was negative significant correlation between ganglion cyst and torn grafts.
Grafts in cyclops cases were normal SI, normal orientation, and intact, and so cyclops had significant negative correlation with graft discontinuity. The two cases of hardware malposition cases had complete torn grafts.
The secondary signs of ACL graft tear as anterior tibial translation, uncovered posterior horn of LM, and PCL buckling, were present in some cases. These signs correlated positively with torn grafts.
The most common associated pathological findings in the knee were synovitis as it was diagnosed in 47% of studied cases. Tears were seen in the posterior horn of the medial meniscus in 41% of cases, and in the PCL in 6%.