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In a prospective study, 153 MRI examinations were performed on 74 patients following reconstruction of a ruptured anterior cruciate ligament with a semitendinosus graft. MRI examinations were performed at three defined intervals (3 months, 4 to 12 months, and 1 to 2 years postoperatively), and the findings were compared to simultaneous clinical tests to define stability criteria. This permitted reliable assessment of the integrity of the ligament graft; in three cases we correctly diagnosed a ruptured graft. A well-defined tendon graft with recognizable fibrous structures correlated with a clinically stable ligament in 98% of the cases. Due to physiological transformation occurring from three months to one year postoperatively, that graft temporarily appears less distinct. Complete integration of the graft with full stability of the knee is visualized in the MRI scan as a tendon with low signal intensity. Postoperative complications and the desire to participate in sports activities are indications for MRI examination.
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