MRI signs of remodelling of quadriceps tendon and hamstring tendon grafts after primary reconstruction of the anterior cruciate ligament

AIM: To study the MRI signs of HT and QT grafts remodeling after primary ACL reconstruction.

Methods

We analyzed the case histories of adult patients with complete rupture of the ACL who underwent surgery in the Department of Traumatology and Orthopedics of the FNCC of the FMBA of Russia from 2010 to 2025. On the postoperative MRI scans we measured the diameter of the graft, assessed the signal intensity from the graft and bone marrow around the bone channels, and the severity of knee synovitis. The data were compared in groups with different types of grafts and duration of the postoperative period.

Results

The average thickness of the QT graft was greater than that of the HT graft in general (p=0.000968) and in groups 0-3 and 7-12 months after surgery. Patients under 1 year of follow-up were more likely to have a pathological graft signal (p=0.015), especially in the QT group (60.9%), compared with HT (42.9%), as well as the severity of knee effusion (p=0.006). Moderate knee effusion was more common in the QT group (60.7%), and small effusion in the HT group (48.7%) (p=0.008). The highest incidence of moderate and severe effusion was found for the QT group 0-3 months after surgery (100%), compared with the HT group (69.2%) (p=0.010880). The number of patients with abnormal bone marrow signal around the bone channels decreased between groups 0-3 (78.3%) and 4-6 (36.1%) months (p=0.001). In the QT group, a hyperintensive signal around bone channels of any severity was observed in 50% of patients, and in the HT group – in 31.4% (p=0.063).