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Purpose: To assess the ligamentization of the hamstring graft after arthroscopic anatomic single bundle anterior cruciate ligament (ACL) reconstruction using MRI at one year postoperatively. Patients and Methods: 25 patients (22 males and 03 females) underwent arthroscopic anatomic single bundle ACL reconstruction using hamstring tendon autograft. After ACL reconstruction, the ligamentization of the hamstring graft at one year postoperatively was evaluated on MRI by assessing the signal intensity of the graft and the integration of the graft on the tibial side. The graft integration at the level of the tibial tunnel was evaluated by the presence or absence of synovial fluid at the tunnel-graft interface. Results: MRI signal intensity of the ACL grafts was low in 13 (52%) cases, intermediate in 10 (40%) cases, and high in 1 (4%) case. Presence of synovial fluid at the graft interface was observed in 3 (12%) cases. The graft ligamentization was present in 23 (92%) cases, as indicated by the Figueroa score of 3-5. Conclusion: The phenomenon of ligamentization of ACL grafts after anatomical ACL reconstruction occurs within 1 year after surgery. MRI is a good tool to evaluate graft integration and graft ligamentization after ACL reconstruction.

Graft ligamentization after anatomical single bundle ACL reconstruction using hamstring graft