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Background <p>Although quantitative T2 mapping magnetic resonance imaging (MRI) is recognized as a non-invasive method for assessing graft maturity after anterior cruciate ligament (ACL) reconstruction, its longitudinal changes and association with clinical outcomes within the first postoperative year are not well established. The purpose of this study was to prospectively investigate hamstring autograft maturity via sequential quantitative T2 mapping and to examine its relationship with patient-reported outcomes and return to sports during the first year after ACL reconstruction.</p> Methods <p>Twenty-seven patients undergoing primary ACL reconstruction with hamstring tendon autografts were enrolled for MRI scans at 3, 6, and 12&#xa0;months after surgery, and 15 patients with healthy ACLs served as controls. The quantitative MRI-based T2 relaxation time and conventional MRI-based signal/noise quotient (SNQ) of the graft were calculated and correlated with the Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and return to preinjury sports levels.</p> Results <p>T2 relaxation times and SNQ values of the grafts increased from 3 to 6&#xa0;months (<i>p</i> &lt; 0.01) and then decreased from 6 to 12&#xa0;months postoperatively (<i>p</i> &lt; 0.05). Graft T2 relaxation times were significantly lower than those of native ACLs at 3, 6, and 12&#xa0;months postoperatively (<i>p</i> &lt; 0.01). A significant negative correlation was observed between graft T2 relaxation time and the Lysholm score at 6&#xa0;months postoperatively (<i>p</i> = 0.028), as well as with the KOOS pain subscale at 12&#xa0;months (<i>p</i> = 0.023). Patients returning to preinjury sports levels at 12&#xa0;months postoperatively had relatively lower graft T2 relaxation times (<i>p</i> = 0.045) and SNQ values (<i>p</i> = 0.043) compared to those who did not.</p> Conclusions <p>The graft T2 relaxation time and SNQ value increased during the first 6&#xa0;months, followed by a subsequent reduction from 6 to 12&#xa0;months after ACL reconstruction, and graft T2 relaxation time showed significant negative correlations with the Lysholm score at 6&#xa0;months and with the KOOS pain subscale at 12&#xa0;months postoperatively. Successful return to preinjury sports levels at 12&#xa0;months was associated with lower graft T2 relaxation times and SNQ values. Quantitative MRI T2 mapping may provide an important assessment technique for monitoring graft maturation and guiding return to sports.</p>

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Autograft maturation assessed by sequential quantitative MR T2 mapping and its correlation with patient-reported outcomes and return to sports during the first year after anterior cruciate ligament reconstruction

  • 期刊论文

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  • 发表日期：

    2026年1月27日

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  • Yingchang Pang,
  • Sibo Xu,
  • Gengxian Xiang,
  • Kaiqi Zhang,
  • Tiezheng Sun

摘要

Background

Although quantitative T2 mapping magnetic resonance imaging (MRI) is recognized as a non-invasive method for assessing graft maturity after anterior cruciate ligament (ACL) reconstruction, its longitudinal changes and association with clinical outcomes within the first postoperative year are not well established. The purpose of this study was to prospectively investigate hamstring autograft maturity via sequential quantitative T2 mapping and to examine its relationship with patient-reported outcomes and return to sports during the first year after ACL reconstruction.

Methods

Twenty-seven patients undergoing primary ACL reconstruction with hamstring tendon autografts were enrolled for MRI scans at 3, 6, and 12 months after surgery, and 15 patients with healthy ACLs served as controls. The quantitative MRI-based T2 relaxation time and conventional MRI-based signal/noise quotient (SNQ) of the graft were calculated and correlated with the Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and return to preinjury sports levels.

Results

T2 relaxation times and SNQ values of the grafts increased from 3 to 6 months (p < 0.01) and then decreased from 6 to 12 months postoperatively (p < 0.05). Graft T2 relaxation times were significantly lower than those of native ACLs at 3, 6, and 12 months postoperatively (p < 0.01). A significant negative correlation was observed between graft T2 relaxation time and the Lysholm score at 6 months postoperatively (p = 0.028), as well as with the KOOS pain subscale at 12 months (p = 0.023). Patients returning to preinjury sports levels at 12 months postoperatively had relatively lower graft T2 relaxation times (p = 0.045) and SNQ values (p = 0.043) compared to those who did not.

Conclusions

The graft T2 relaxation time and SNQ value increased during the first 6 months, followed by a subsequent reduction from 6 to 12 months after ACL reconstruction, and graft T2 relaxation time showed significant negative correlations with the Lysholm score at 6 months and with the KOOS pain subscale at 12 months postoperatively. Successful return to preinjury sports levels at 12 months was associated with lower graft T2 relaxation times and SNQ values. Quantitative MRI T2 mapping may provide an important assessment technique for monitoring graft maturation and guiding return to sports.