ARRS 2022 Abstracts

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E2111. Review of Complications Related to Anterior Cruciate Ligament Reconstruction and Repair
Authors
  1. Kevin Junus; Department of Radiology, Keck School of Medicine, University of Southern California
  2. Dakshesh Patel; Department of Radiology, Keck School of Medicine, University of Southern California
  3. Eric White; Department of Radiology, Keck School of Medicine, University of Southern California
  4. Jordan Gross; Department of Radiology, Keck School of Medicine, University of Southern California
Background
For several years, graft reconstruction of a disrupted anterior cruciate ligament (ACL) has been the standard of care for young patients; specifically, to prevent further meniscal or cartilage degeneration related to joint instability in the setting of ligamentous insufficiency. It is one of the most common procedures performed in sports medicine and is often performed arthroscopically with the use of autologous or allogenic grafts. Incidence of failure of ACL reconstruction ranges from 6–12%; this includes both short-term and long-term complications. There are many newer and novel techniques, including ACL repair or reconstruction with internal bracing, that have been developed to improve functional outcomes.

Educational Goals / Teaching Points
The goals of this exhibit are to review common surgical techniques utilized in ACL reconstruction and repair and how they present on imaging; review the expected postoperative appearance of common ACL reconstruction or repair techniques with a multimodality approach; and review associated complications in the short and long-term post-operative setting.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This educational exhibit is targeted toward trainees to provide a review of normal and abnormal cases seen in both the early and late postoperative setting. There is a wide range of surgical techniques that are used in attempts to restore ACL function after a tear, including different types of grafts (e.g., bone-patellar tendon-bone, quadriceps tendon-bone) or surgical procedures (i.e., ACL repair or reconstruction using internal bracing). There are unique considerations that may result in early postoperative graft failure, including suboptimal positioning of tibial and femoral tunnels for biomechanical optimization. Later complications include cystic graft and tunnel degeneration, arthrofibrosis, and hardware or graft loosening, among other complications, all of which will be presented in a multimodality, case-based fashion.

Conclusion
ACL reconstruction and/or repair is one of the most common orthopedic surgical procedures, and there is a wide array of surgical procedures and techniques used to address ACL insufficiency. Understanding of the normal and abnormal post-surgical appearance is important for radiologists for appropriate clinical management.