Changes in Cross-sectional Area and Signal Intensity of Healing Anterior Cruciate Ligaments and Grafts in the First 2 Years After Surgery
Background: The quality of a repaired anterior cruciate ligament (ACL) or reconstructed graft is typically quantified in clinical studies by evaluating knee, lower extremity, or patient performance. However, magnetic resonance imaging of the healing ACL or graft may provide a more direct measure of...
Gespeichert in:
| Veröffentlicht in: | The American journal of sports medicine 2019-07, Vol.47 (8), p.1831-1843 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1843 |
|---|---|
| container_issue | 8 |
| container_start_page | 1831 |
| container_title | The American journal of sports medicine |
| container_volume | 47 |
| creator | Kiapour, Ata M. Ecklund, Kirsten Murray, Martha M. Flutie, Brett Freiberger, Christina Henderson, Rachael Kramer, Dennis Micheli, Lyle Thurber, Laura Yen, Yi-Meng Fleming, Braden C. |
| description | Background:
The quality of a repaired anterior cruciate ligament (ACL) or reconstructed graft is typically quantified in clinical studies by evaluating knee, lower extremity, or patient performance. However, magnetic resonance imaging of the healing ACL or graft may provide a more direct measure of tissue quality (ie, signal intensity) and quantity (ie, cross-sectional area).
Hypotheses:
(1) Average cross-sectional area or signal intensity of a healing ACL after bridge-enhanced ACL repair (BEAR) or a hamstring autograft (ACL reconstruction) will change postoperatively from 3 to 24 months. (2) The average cross-sectional area and signal intensity of the healing ligament or graft will correlate with anatomic features of the knee associated with ACL injury.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients with a complete midsubstance ACL tear who were treated with either BEAR (n = 10) or ACL reconstruction (n = 10) underwent magnetic resonance imaging at 3, 6, 12, and 24 months after surgery. Images were analyzed to determine the average cross-sectional area and signal intensity of the ACL or graft at each time point. ACL orientation, stump length, and bony anatomy were also assessed.
Results:
Mean cross-sectional area of the grafts was 48% to 98% larger than the contralateral intact ACLs at all time points (P < .01). The BEAR ACLs were 23% to 28% greater in cross-sectional area than the contralateral intact ACLs at 3 and 6 months (P < .02) but similar at 12 and 24 months. The BEAR ACLs were similar in sagittal orientation to the contralateral ACLs, while the grafts were 6.5° more vertical (P = .005). For the BEAR ACLs, a bigger notch correlated with a bigger cross-sectional area, while a shorter ACL femoral stump, steeper lateral tibial slope, and shallower medial tibial depth were associated with higher signal intensity (R2 > .40, P < .05). Performance of notchplasty resulted in an increased ACL cross-sectional area after the BEAR procedure (P = .007). No anatomic features were correlated with ACL graft size or signal intensity.
Conclusion:
Hamstring autografts were larger in cross-sectional area and more vertically oriented than the native ACLs at 24 months after surgery. BEAR ACLs had a cross-sectional area, signal intensity, and sagittal orientation similar to the contralateral ACLs at 24 months. The early signal intensity and cross-sectional area of the repaired ACL may be affected by specific anatomic features, including lateral tibi |
| doi_str_mv | 10.1177/0363546519850572 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2250632170</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546519850572</sage_id><sourcerecordid>2248970078</sourcerecordid><originalsourceid>FETCH-LOGICAL-c407t-81c4736ea4900c5f36132aaa49d38b619ceec13468fb487e4c97e80120ba72153</originalsourceid><addsrcrecordid>eNp1kT1rHDEQhkVwsC-2-1RG4CbNJiNp9bHlccQfcJDCSZFq0elm1zJ7WlvSFvcT_K-j9dkJGFINM_O878C8hHxm8JUxrb-BUELWSrLGSJCafyALJiWvhFDyiCzmdTXvT8inlB4AgGlljsmJYEwpDWxBnlf3NvSYqA90FceUqoQu-zHYgS4jWmrDlt75fu5vQ8aQfN7TsaM3aAcferosw-jHWNST8zYjXfve7jDk9KK9jrbLL_b5HumVjylTTn-jjYkuu6Kld1PsMe7PyMfODgnPX-sp-XX1_efqplr_uL5dLdeVq0HnyjBXa6HQ1g2Ak51QTHBrS7sVZqNY4xAdE7Uy3aY2GmvXaDTAOGys5kyKU_Ll4PsYx6cJU253PjkcBhtwnFLLuQQlONNQ0Mt36MM4xfKKmapNowG0KRQcKDf_L2LXPka_s3HfMmjnmNr3MRXJxavxtNnh9q_gLZcCVAcg2R7_Xf2v4R_S8pid</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2248970078</pqid></control><display><type>article</type><title>Changes in Cross-sectional Area and Signal Intensity of Healing Anterior Cruciate Ligaments and Grafts in the First 2 Years After Surgery</title><source>Access via SAGE</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Kiapour, Ata M. ; Ecklund, Kirsten ; Murray, Martha M. ; Flutie, Brett ; Freiberger, Christina ; Henderson, Rachael ; Kramer, Dennis ; Micheli, Lyle ; Thurber, Laura ; Yen, Yi-Meng ; Fleming, Braden C.</creator><creatorcontrib>Kiapour, Ata M. ; Ecklund, Kirsten ; Murray, Martha M. ; Flutie, Brett ; Freiberger, Christina ; Henderson, Rachael ; Kramer, Dennis ; Micheli, Lyle ; Thurber, Laura ; Yen, Yi-Meng ; Fleming, Braden C. ; BEAR Trial Team ; BEAR Trial Team</creatorcontrib><description>Background:
The quality of a repaired anterior cruciate ligament (ACL) or reconstructed graft is typically quantified in clinical studies by evaluating knee, lower extremity, or patient performance. However, magnetic resonance imaging of the healing ACL or graft may provide a more direct measure of tissue quality (ie, signal intensity) and quantity (ie, cross-sectional area).
Hypotheses:
(1) Average cross-sectional area or signal intensity of a healing ACL after bridge-enhanced ACL repair (BEAR) or a hamstring autograft (ACL reconstruction) will change postoperatively from 3 to 24 months. (2) The average cross-sectional area and signal intensity of the healing ligament or graft will correlate with anatomic features of the knee associated with ACL injury.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients with a complete midsubstance ACL tear who were treated with either BEAR (n = 10) or ACL reconstruction (n = 10) underwent magnetic resonance imaging at 3, 6, 12, and 24 months after surgery. Images were analyzed to determine the average cross-sectional area and signal intensity of the ACL or graft at each time point. ACL orientation, stump length, and bony anatomy were also assessed.
Results:
Mean cross-sectional area of the grafts was 48% to 98% larger than the contralateral intact ACLs at all time points (P < .01). The BEAR ACLs were 23% to 28% greater in cross-sectional area than the contralateral intact ACLs at 3 and 6 months (P < .02) but similar at 12 and 24 months. The BEAR ACLs were similar in sagittal orientation to the contralateral ACLs, while the grafts were 6.5° more vertical (P = .005). For the BEAR ACLs, a bigger notch correlated with a bigger cross-sectional area, while a shorter ACL femoral stump, steeper lateral tibial slope, and shallower medial tibial depth were associated with higher signal intensity (R2 > .40, P < .05). Performance of notchplasty resulted in an increased ACL cross-sectional area after the BEAR procedure (P = .007). No anatomic features were correlated with ACL graft size or signal intensity.
Conclusion:
Hamstring autografts were larger in cross-sectional area and more vertically oriented than the native ACLs at 24 months after surgery. BEAR ACLs had a cross-sectional area, signal intensity, and sagittal orientation similar to the contralateral ACLs at 24 months. The early signal intensity and cross-sectional area of the repaired ACL may be affected by specific anatomic features, including lateral tibial slope and notch width—observations that deserve further study in a larger cohort of patients.
Registration:
NCT02292004 (ClinicalTrials.gov identifier)</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546519850572</identifier><identifier>PMID: 31166701</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Anterior Cruciate Ligament - surgery ; Anterior Cruciate Ligament Injuries - surgery ; Anterior Cruciate Ligament Reconstruction - methods ; Autografts - surgery ; Cohort Studies ; Female ; Hamstring Muscles - surgery ; Humans ; Knee ; Knee Joint - surgery ; Magnetic Resonance Imaging ; Male ; NMR ; Nuclear magnetic resonance ; Postoperative Period ; Sports medicine ; Surgery ; Transplantation, Autologous ; Young Adult</subject><ispartof>The American journal of sports medicine, 2019-07, Vol.47 (8), p.1831-1843</ispartof><rights>2019 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-81c4736ea4900c5f36132aaa49d38b619ceec13468fb487e4c97e80120ba72153</citedby><cites>FETCH-LOGICAL-c407t-81c4736ea4900c5f36132aaa49d38b619ceec13468fb487e4c97e80120ba72153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546519850572$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546519850572$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,781,785,21823,27928,27929,43625,43626</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31166701$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kiapour, Ata M.</creatorcontrib><creatorcontrib>Ecklund, Kirsten</creatorcontrib><creatorcontrib>Murray, Martha M.</creatorcontrib><creatorcontrib>Flutie, Brett</creatorcontrib><creatorcontrib>Freiberger, Christina</creatorcontrib><creatorcontrib>Henderson, Rachael</creatorcontrib><creatorcontrib>Kramer, Dennis</creatorcontrib><creatorcontrib>Micheli, Lyle</creatorcontrib><creatorcontrib>Thurber, Laura</creatorcontrib><creatorcontrib>Yen, Yi-Meng</creatorcontrib><creatorcontrib>Fleming, Braden C.</creatorcontrib><creatorcontrib>BEAR Trial Team</creatorcontrib><creatorcontrib>BEAR Trial Team</creatorcontrib><title>Changes in Cross-sectional Area and Signal Intensity of Healing Anterior Cruciate Ligaments and Grafts in the First 2 Years After Surgery</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
The quality of a repaired anterior cruciate ligament (ACL) or reconstructed graft is typically quantified in clinical studies by evaluating knee, lower extremity, or patient performance. However, magnetic resonance imaging of the healing ACL or graft may provide a more direct measure of tissue quality (ie, signal intensity) and quantity (ie, cross-sectional area).
Hypotheses:
(1) Average cross-sectional area or signal intensity of a healing ACL after bridge-enhanced ACL repair (BEAR) or a hamstring autograft (ACL reconstruction) will change postoperatively from 3 to 24 months. (2) The average cross-sectional area and signal intensity of the healing ligament or graft will correlate with anatomic features of the knee associated with ACL injury.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients with a complete midsubstance ACL tear who were treated with either BEAR (n = 10) or ACL reconstruction (n = 10) underwent magnetic resonance imaging at 3, 6, 12, and 24 months after surgery. Images were analyzed to determine the average cross-sectional area and signal intensity of the ACL or graft at each time point. ACL orientation, stump length, and bony anatomy were also assessed.
Results:
Mean cross-sectional area of the grafts was 48% to 98% larger than the contralateral intact ACLs at all time points (P < .01). The BEAR ACLs were 23% to 28% greater in cross-sectional area than the contralateral intact ACLs at 3 and 6 months (P < .02) but similar at 12 and 24 months. The BEAR ACLs were similar in sagittal orientation to the contralateral ACLs, while the grafts were 6.5° more vertical (P = .005). For the BEAR ACLs, a bigger notch correlated with a bigger cross-sectional area, while a shorter ACL femoral stump, steeper lateral tibial slope, and shallower medial tibial depth were associated with higher signal intensity (R2 > .40, P < .05). Performance of notchplasty resulted in an increased ACL cross-sectional area after the BEAR procedure (P = .007). No anatomic features were correlated with ACL graft size or signal intensity.
Conclusion:
Hamstring autografts were larger in cross-sectional area and more vertically oriented than the native ACLs at 24 months after surgery. BEAR ACLs had a cross-sectional area, signal intensity, and sagittal orientation similar to the contralateral ACLs at 24 months. The early signal intensity and cross-sectional area of the repaired ACL may be affected by specific anatomic features, including lateral tibial slope and notch width—observations that deserve further study in a larger cohort of patients.
Registration:
NCT02292004 (ClinicalTrials.gov identifier)</description><subject>Anterior Cruciate Ligament - surgery</subject><subject>Anterior Cruciate Ligament Injuries - surgery</subject><subject>Anterior Cruciate Ligament Reconstruction - methods</subject><subject>Autografts - surgery</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Hamstring Muscles - surgery</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Joint - surgery</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Postoperative Period</subject><subject>Sports medicine</subject><subject>Surgery</subject><subject>Transplantation, Autologous</subject><subject>Young Adult</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kT1rHDEQhkVwsC-2-1RG4CbNJiNp9bHlccQfcJDCSZFq0elm1zJ7WlvSFvcT_K-j9dkJGFINM_O878C8hHxm8JUxrb-BUELWSrLGSJCafyALJiWvhFDyiCzmdTXvT8inlB4AgGlljsmJYEwpDWxBnlf3NvSYqA90FceUqoQu-zHYgS4jWmrDlt75fu5vQ8aQfN7TsaM3aAcferosw-jHWNST8zYjXfve7jDk9KK9jrbLL_b5HumVjylTTn-jjYkuu6Kld1PsMe7PyMfODgnPX-sp-XX1_efqplr_uL5dLdeVq0HnyjBXa6HQ1g2Ak51QTHBrS7sVZqNY4xAdE7Uy3aY2GmvXaDTAOGys5kyKU_Ll4PsYx6cJU253PjkcBhtwnFLLuQQlONNQ0Mt36MM4xfKKmapNowG0KRQcKDf_L2LXPka_s3HfMmjnmNr3MRXJxavxtNnh9q_gLZcCVAcg2R7_Xf2v4R_S8pid</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Kiapour, Ata M.</creator><creator>Ecklund, Kirsten</creator><creator>Murray, Martha M.</creator><creator>Flutie, Brett</creator><creator>Freiberger, Christina</creator><creator>Henderson, Rachael</creator><creator>Kramer, Dennis</creator><creator>Micheli, Lyle</creator><creator>Thurber, Laura</creator><creator>Yen, Yi-Meng</creator><creator>Fleming, Braden C.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>201907</creationdate><title>Changes in Cross-sectional Area and Signal Intensity of Healing Anterior Cruciate Ligaments and Grafts in the First 2 Years After Surgery</title><author>Kiapour, Ata M. ; Ecklund, Kirsten ; Murray, Martha M. ; Flutie, Brett ; Freiberger, Christina ; Henderson, Rachael ; Kramer, Dennis ; Micheli, Lyle ; Thurber, Laura ; Yen, Yi-Meng ; Fleming, Braden C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-81c4736ea4900c5f36132aaa49d38b619ceec13468fb487e4c97e80120ba72153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Anterior Cruciate Ligament - surgery</topic><topic>Anterior Cruciate Ligament Injuries - surgery</topic><topic>Anterior Cruciate Ligament Reconstruction - methods</topic><topic>Autografts - surgery</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Hamstring Muscles - surgery</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Joint - surgery</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Postoperative Period</topic><topic>Sports medicine</topic><topic>Surgery</topic><topic>Transplantation, Autologous</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kiapour, Ata M.</creatorcontrib><creatorcontrib>Ecklund, Kirsten</creatorcontrib><creatorcontrib>Murray, Martha M.</creatorcontrib><creatorcontrib>Flutie, Brett</creatorcontrib><creatorcontrib>Freiberger, Christina</creatorcontrib><creatorcontrib>Henderson, Rachael</creatorcontrib><creatorcontrib>Kramer, Dennis</creatorcontrib><creatorcontrib>Micheli, Lyle</creatorcontrib><creatorcontrib>Thurber, Laura</creatorcontrib><creatorcontrib>Yen, Yi-Meng</creatorcontrib><creatorcontrib>Fleming, Braden C.</creatorcontrib><creatorcontrib>BEAR Trial Team</creatorcontrib><creatorcontrib>BEAR Trial Team</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kiapour, Ata M.</au><au>Ecklund, Kirsten</au><au>Murray, Martha M.</au><au>Flutie, Brett</au><au>Freiberger, Christina</au><au>Henderson, Rachael</au><au>Kramer, Dennis</au><au>Micheli, Lyle</au><au>Thurber, Laura</au><au>Yen, Yi-Meng</au><au>Fleming, Braden C.</au><aucorp>BEAR Trial Team</aucorp><aucorp>BEAR Trial Team</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in Cross-sectional Area and Signal Intensity of Healing Anterior Cruciate Ligaments and Grafts in the First 2 Years After Surgery</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2019-07</date><risdate>2019</risdate><volume>47</volume><issue>8</issue><spage>1831</spage><epage>1843</epage><pages>1831-1843</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><abstract>Background:
The quality of a repaired anterior cruciate ligament (ACL) or reconstructed graft is typically quantified in clinical studies by evaluating knee, lower extremity, or patient performance. However, magnetic resonance imaging of the healing ACL or graft may provide a more direct measure of tissue quality (ie, signal intensity) and quantity (ie, cross-sectional area).
Hypotheses:
(1) Average cross-sectional area or signal intensity of a healing ACL after bridge-enhanced ACL repair (BEAR) or a hamstring autograft (ACL reconstruction) will change postoperatively from 3 to 24 months. (2) The average cross-sectional area and signal intensity of the healing ligament or graft will correlate with anatomic features of the knee associated with ACL injury.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients with a complete midsubstance ACL tear who were treated with either BEAR (n = 10) or ACL reconstruction (n = 10) underwent magnetic resonance imaging at 3, 6, 12, and 24 months after surgery. Images were analyzed to determine the average cross-sectional area and signal intensity of the ACL or graft at each time point. ACL orientation, stump length, and bony anatomy were also assessed.
Results:
Mean cross-sectional area of the grafts was 48% to 98% larger than the contralateral intact ACLs at all time points (P < .01). The BEAR ACLs were 23% to 28% greater in cross-sectional area than the contralateral intact ACLs at 3 and 6 months (P < .02) but similar at 12 and 24 months. The BEAR ACLs were similar in sagittal orientation to the contralateral ACLs, while the grafts were 6.5° more vertical (P = .005). For the BEAR ACLs, a bigger notch correlated with a bigger cross-sectional area, while a shorter ACL femoral stump, steeper lateral tibial slope, and shallower medial tibial depth were associated with higher signal intensity (R2 > .40, P < .05). Performance of notchplasty resulted in an increased ACL cross-sectional area after the BEAR procedure (P = .007). No anatomic features were correlated with ACL graft size or signal intensity.
Conclusion:
Hamstring autografts were larger in cross-sectional area and more vertically oriented than the native ACLs at 24 months after surgery. BEAR ACLs had a cross-sectional area, signal intensity, and sagittal orientation similar to the contralateral ACLs at 24 months. The early signal intensity and cross-sectional area of the repaired ACL may be affected by specific anatomic features, including lateral tibial slope and notch width—observations that deserve further study in a larger cohort of patients.
Registration:
NCT02292004 (ClinicalTrials.gov identifier)</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>31166701</pmid><doi>10.1177/0363546519850572</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0363-5465 |
| ispartof | The American journal of sports medicine, 2019-07, Vol.47 (8), p.1831-1843 |
| issn | 0363-5465 1552-3365 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2250632170 |
| source | Access via SAGE; MEDLINE; Alma/SFX Local Collection |
| subjects | Anterior Cruciate Ligament - surgery Anterior Cruciate Ligament Injuries - surgery Anterior Cruciate Ligament Reconstruction - methods Autografts - surgery Cohort Studies Female Hamstring Muscles - surgery Humans Knee Knee Joint - surgery Magnetic Resonance Imaging Male NMR Nuclear magnetic resonance Postoperative Period Sports medicine Surgery Transplantation, Autologous Young Adult |
| title | Changes in Cross-sectional Area and Signal Intensity of Healing Anterior Cruciate Ligaments and Grafts in the First 2 Years After Surgery |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-17T09%3A43%3A29IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Changes%20in%20Cross-sectional%20Area%20and%20Signal%20Intensity%20of%20Healing%20Anterior%20Cruciate%20Ligaments%20and%20Grafts%20in%20the%20First%202%20Years%20After%20Surgery&rft.jtitle=The%20American%20journal%20of%20sports%20medicine&rft.au=Kiapour,%20Ata%20M.&rft.aucorp=BEAR%20Trial%20Team&rft.date=2019-07&rft.volume=47&rft.issue=8&rft.spage=1831&rft.epage=1843&rft.pages=1831-1843&rft.issn=0363-5465&rft.eissn=1552-3365&rft_id=info:doi/10.1177/0363546519850572&rft_dat=%3Cproquest_cross%3E2248970078%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2248970078&rft_id=info:pmid/31166701&rft_sage_id=10.1177_0363546519850572&rfr_iscdi=true |