A standard series of plain radiographs consisting of a standing anteroposterior, Rosenberg (weight bearing posteroanterior in 45 degrees of flexion), and Merchant views of both knees, as well as a lateral of the affected side should be examined for tunnel position, tunnel enlargement, and failure of fixation (see Fig. 523). Clinical evidence of angular malalignment should be further evaluated with standing, long-cassette views of both lower extremities. The presence of significant tunnel enlargement

Figure 52-4 Magnetic resonance imaging of a failed anterior cruciate ligament reconstruction using Achilles tendon allograft reveals marked enlargement of the tibial tunnel that required staged treatment with tunnel debridement and grafting followed by reconstruction.

on a plain radiograph may require evaluation with computed tomography or magnetic resonance imaging (MRI) to determine whether a single or staged procedure should be undertaken (Fig. 52-4).12 Furthermore, MRI can be useful in identifying intra-articular pathology that may require attention at the time of a revision procedure, such as chondral defects, meniscal tears, and presence of a cyclops lesion. Because instability can exist in the presence of a radiographically intact graft, however, MRI should be relied on to confirm or rule out graft failure. Failure is a clinical, not radiographic, diagnosis.

Was this article helpful?

0 0
Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

Get My Free Ebook

Post a comment