Degenerative change in post-op ACL reconstruction

Case contributed by Andrew Lawson
Diagnosis certain

Presentation

Pain post ACL reconstruction and instability.

Patient Data

Age: 23
Gender: Male

Substantial susceptibility artefact results from the ACL reconstruction. Subtle curvilinear high signal in the posterior horn of the medial meniscus extending from the femoral articular surface suspicious for a non-displaced tear. The medial collateral ligaments are intact. Minimal marginal osteophyte formation has developed around the medial femoral condyle. Low signal graft material is demonstrated in both the femoral and tibial tunnels. At the level of the intercondylar notch, the graft is stretched and markedly attenuated. There is anterior translation of the tibia. Minor athrofibrosis in the infra-patellar fat. The PCL is intact. Abnormal configuration to the posterior root of the lateral meniscus suggestive of a previous surgical resection. The remainder of the meniscus is intact. The lateral collateral ligament is intact. The extensor compartment is unremarkable with no evidence of chondromalacia. The marrow signal is is mildly reduced for age.

Comment 1. marked attenuation of the ACL graft at the level of the intercondylar notch. 2. subtle signal abnormality in the posterior horn of the medial meniscus suspicious for a tear. 3. no evidence of a recent pivot injury.

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