(Fig 2-D.09) ACL Graft complete tear

https://youtu.be/tSybCcdOssg

https://youtu.be/rbdodKV6lpE

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1️⃣ Graft Tear

✅ Susceptibility to Injury

• Grafts are most vulnerable during the remodeling process, typically 4–8 months post-surgery.

✅ Primary Signs of Injury

• Graft Signal Abnormalities: Increased signal on T2-weighted MRI sequences.
• Graft Thickness: Variations in the thickness of the graft.
• Fiber Discontinuity: Breaks or interruptions in the continuity of graft fibers.

✅ Secondary Signs of Injury

• Anterior Tibial Translation: Forward movement of the tibia relative to the femur.
• Uncovered Posterior Horn of the Lateral Meniscus: Lack of coverage by the graft.
• Buckling of the Posterior Cruciate Ligament: Abnormal bending or collapsing.

 

2️⃣ Differentiating Graft Impingement from Graft Tear

✅ Diagnostic Approach

• Utilizing primary signs of graft discontinuity and thickness, alongside secondary indicators and the patient's clinical history (such as laxity vs. decreased range of motion), aids in resolving ambiguous cases.
• Fluid Signal on T2-Weighted Sequences: A strong indication of graft disruption, visible within the graft itself.

 

AJR 2010; 194:476–484

 

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