Association of Graft Maturity on MRI With Return to Sports at 9 Months After Primary Single-Bundle ACL Reconstruction With Autologous Hamstring Graft.

Background: The relationship between graft maturity on magnetic resonance imaging (MRI) and return to sports (RTS) after anterior cruciate ligament (ACL) reconstruction is unclear. Purpose: To compare signal-to-noise quotient (SNQ) values and ACL graft T2* (gradient echo) values between patients who did RTS and those who did not RTS (NRTS) after ACL reconstruction and to evaluate the predictive value of T2* mapping for RTS after ACL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: At a minimum of 9 months after arthroscopic single-bundle ACL reconstruction with autologous hamstring tendon graft, 82 patients underwent RTS assessment as well as MRI evaluation. The patients were classified into RTS (n = 53) and NRTS (n = 29) groups based on the results of the assessment. The SNQ values in the proximal, middle, and distal regions of the graft and the T2* values of the graft were measured on MRI. The correlation between T2* values and RTS was assessed using Spearman correlation analysis. Receiver operating characteristic curves were constructed to compare the diagnostic performance, and the optimal T2* cutoff value for detecting RTS was determined based on the maximum Youden index. Results: At 9 months after ACL reconstruction, the proximal, middle, and mean SNQ values in the RTS group were significantly lower than those in the NRTS group (proximal: 17.15 ± 4.85 vs 19.55 ± 5.05, Conclusion: Study findings indicated that the SNQs (mean, proximal, and middle) and the T2* values of the graft in the RTS group were significantly lower than those in NRTS group. A T2* value of 16.65 was calculated to predict patients who failed RTS tests with a sensitivity of 67.9% and specificity of 88.2%.