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MR Imaging of the Posterior Cruciate Ligament Graft: Initial Experience in 15 Patients with Clinical Correlation¹

¹ From the Departments of Radiology (P.M.S., T.G.S.) and Orthopedic Surgery (H.T.L.), Wilford Hall Medical Center, 759 MDTS/MTRD, 2200 Bergquist Dr, Ste 1, Lackland AFB, TX 78236-5300; the Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (W.B.M., M.E.S.); and the Department of Radiology, U.S. Air Force Academy Hospital, USAFA, Colo (C.A.N.). From the 2000 RSNA scientific assembly. Received December 8, 2000; revision requested January 8, 2001; revision received March 20; accepted April 9. Address correspondence to P.M.S. (e-mail: paul.sherman@usafa90.com).

PURPOSE: To describe the magnetic resonance (MR) appearance of the posterior cruciate ligament (PCL) graft in the 1st postoperative year and to correlate the MR findings with clinical examination findings.

MATERIALS AND METHODS: Nineteen MR examinations were performed in 15 patients (with 15 grafts) 1–33 months after PCL reconstruction. Results of clinical follow-up were available in 14 patients. Graft shape and thickness were recorded, and intrasubstance signal intensity at T2-weighted imaging was graded. The MR findings were correlated with the time between surgery and clinical examination.

RESULTS: At MR imaging, 13 grafts appeared intact, one could not be assessed owing to hardware artifact, and one initially appeared disrupted. Graft thickness was 7–19 mm. There was no significant difference between graft thickness versus time since surgery and signal intensity versus time since surgery (P = .14). In two of three patients who underwent sequential MR examinations, graft thickness and intrasubstance signal intensity decreased as the time between reconstruction and MR imaging increased. Two of 14 patients who underwent physical examination had a posterior drawer, and one also had an anterior cruciate ligament graft tear. Both patients with knee instability demonstrated intact PCL graft fibers at MR imaging. There was no correlation between knee stability and graft thickness, signal intensity, or shape.

CONCLUSION: After PCL reconstruction, MR imaging in the 1st year depicts a thickened graft with increased signal intensity. There does not appear to be a relationship between clinical stability and findings at MR imaging.

Index terms: Grafts, 4526.459 • Knee, ligaments, menisci, and cartilage, 4526.459 • Knee, MR, 4526.121411