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J Orthop Res. 2015 Aug;33(8):1180-7. doi: 10.1002/jor.22874. Epub 2015 Apr 10.

T2* relaxometry and volume predict semi-quantitative histological scoring of an ACL bridge-enhanced primary repair in a porcine model.

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Department of Orthopaedics, Warren Alpert Medical School, Brown University/Rhode Island Hospital, Suite 404, 1 Hoppin Street, Providence, Rhode Island.
School of Engineering, Brown University, Providence, Rhode Island.
Department of Orthopaedic Surgery, Children's Hospital Boston, Boston, Massachusetts.
Department of Neuroscience, Division of Biology and Medicine, Brown University, Providence, Rhode Island.


Magnetic resonance imaging (MRI) variables, such as T2* and volume, can predict the healing ligament structural properties. How these MR variables relate to semi-quantitative histology of the healing ACL is yet unknown. We hypothesized that T2* and volume would predict the histological scoring of a healing ACL. Yucatan minipigs underwent ACL transection and received bridge-enhanced ACL repair or no treatment. The surgical legs were harvested after 52 weeks and imaged using a high resolution 2-echo sequence. For each ligament, the volume and median T2* values were determined. The ACL specimens were then histologically analyzed using the advanced Ligament Maturity Index (LMI). The T2* of the healing ligaments significantly predicted the total LMI score as well as the cell, collagen and vessel sub-scores; R(2)  = 0.78, 0.67, 0.65, and 0.60, respectively (p ≤ 0.001). The ligament volume also predicted the total LMI score, cell, and collagen sub-scores; R(2)  = 0.39, 0.33, 0.37, and 0.60, respectively (p ≤ 0.001). A lower ligament T2* or a higher volume was associated with higher histological scores of the healing ligaments. This study provides a critical step in the development of a non-invasive method to evaluate ligament healing on a microscopic scale.


ACL; MRI; healing; histology; ligament

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