Knee Surg Relat Res 2019 Mar; 31(1): 37-43
Analysis of Mechanical Loading after Anatomic Anterior Cruciate Ligament Reconstruction Using Combined Single-Photon Emission Computerized Tomography and Conventional Computerized Tomography
Byung Kag Kim, MD1, Tae Won Kim, MD2, Chul Ho Hwang, MD2, Hong Ki Park, MD2, Kyung Hoon Hwang, MD3, Jae Ang Sim, MD2, Yong Seuk Lee, MD4, and Beom Koo Lee, MD5
¹Department of Orthopedic Surgery, Joint Center, Sungmin Hospital, Incheon; 2Department of Orthopedic Surgery, Gil Medical Center, Incheon; 3Department of Nuclear Medicine, Gil Medical Center, Incheon; 4Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam; 5Department of Orthopedic Surgery, The Armed Forces Capital Hospital, Incheon, Korea
Correspondence to: Beom Koo Lee, MD Department of Orthopedic Surgery, The Armed Forces Capital Hospital, Saemaeul-ro 177beon-gil, Bundang-gu, Seongnam 13574, Korea Tel: +82-31-725-6162, Fax: +82-31-725-6129 E-mail:
Received: January 28, 2018; Revised: September 24, 2018; Accepted: October 22, 2018; Published online: March 1, 2019.
© Korean Knee Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: This study was to evaluate changes of the mechanical loading pattern after anatomic anterior cruciate ligament (ACL) reconstruction by analyzing uptake patterns using combined single-photon emission computerized tomography and conventional computerized tomography (SPECT/CT).
Materials and Methods: On SPECT/CT, high signal intensity of the articular surface which shows biological activity and mean increase of mechanical loading was compared with that of the tibiofemoral shaft as a comparative signal. The proportion of positive signals was evaluated in all compartments of the operated knee. Analysis was performed according to combined injury.
Results: A relatively high proportion of positive signals was detected in the posterior zone of the lateral tibial plateau (23.5%) and trochlear groove (23.5%) although increased signal intensity was detected in all compartments. There was no statistical difference depending on the presence of combined injury and between single-bundle and double-bundle ACL reconstruction.
Conclusions: Following anatomic ACL reconstruction, higher signal intensity was detected, particularly in the posterior part of the lateral tibial plateau and trochlear groove. Close observation for further signal changes or osteoarthritic changes would be required even if there was no combined injury and anatomic reconstruction was performed.
Keywords: Knee, Anterior cruciate ligament, Reconstruction, Computerized tomography, SPECT


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