PMC5850882_01
Sagittal T2 images show that the reconstructed graft has a homogeneous low-intensity signal indistinguishable from that of the PCL or patellar tendon, and a good integration within the bone tunnel, demonstrating matured ligamentization. The Howell graft signal assessment was grade II11; Grade I designated a zone filled with a graft that had a homogeneous low-intensity signal indistinguishable from that of the PCL or patellar tendon, grade II designated a volume of the graft analyzed on multiple slices of at least 50% of the normal ligament signal intermixed with portions of the graft that had acquired increased signal intensity, grade III designated a graft within a zone that had less than 50% of its volume exhibiting a normal-appearing ligament signal, and grade IV designated a diffuse increase in the signal intensity with no normal-appearing strands of ligament.
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fig1
The Howell graft signal assessment, which would correlate with graft maturity, was grade II (Fig. 1). Three years later at the last follow-up the patient was free of complaints.