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How these properties relate to future clinical, functional, and patient\u2010reported outcomes remain unknown. The study objective was to investigate the relationship between non\u2010contemporaneous qMRI measures and traditional outcome measures following Bridge\u2010Enhanced ACL Restoration (BEAR). It was hypothesized that qMRI parameters at 6\u00a0months would be associated with clinical, functional, and\/or patient\u2010reported outcomes at 6\u00a0months, 24\u00a0months, and changes from 6 to 24\u00a0months post\u2010surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data of BEAR patients (<jats:italic>n<\/jats:italic>\u2009=\u200965) from a randomized control trial of BEAR versus ACL reconstruction (BEAR II Trial; NCT02664545) were utilized retrospectively for the present analysis. Images were acquired using the Constructive Interference in Steady State (CISS) sequence at 6\u00a0months post\u2010surgery. Single\u2010leg hop test ratios, arthrometric knee laxity values, and International Knee Documentation Committee (IKDC) subjective scores were determined at 6 and 24\u00a0months post\u2010surgery. The associations between traditional outcomes and MRI measures of normalized signal intensity, mean cross\u2010sectional area (CSA), volume, and estimated failure load of the healing ACL were evaluated based on bivariate correlations and multivariable regression analyses, which considered the potential effects of age, sex, and body mass index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CSA (<jats:italic>r<\/jats:italic>\u2009=\u20090.44, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), volume (<jats:italic>r<\/jats:italic>\u2009=\u20090.44, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), and estimated failure load (<jats:italic>r<\/jats:italic>\u2009=\u20090.48, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) at 6\u00a0months were predictive of the change in single\u2010leg hop ratio from 6 to 24\u00a0months in bivariate analysis. CSA (\u03b2<jats:sub>standardized<\/jats:sub>\u2009=\u20090.42, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), volume (\u03b2<jats:sub>standardized<\/jats:sub>\u2009=\u20090.42, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), and estimated failure load (\u03b2<jats:sub>standardized<\/jats:sub>\u2009=\u20090.48, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) remained significant predictors when considering the demographic variables. No significant associations were observed between MRI variables and either knee laxity or IKDC when adjusting for demographic variables. Signal intensity was also not significant at any timepoint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The qMRI\u2010based measures of CSA, volume, and estimated failure load were predictive of a positive functional outcome trajectory from 6 to 24\u00a0months post\u2010surgery. These variables measured using qMRI at 6\u00a0months post\u2010surgery could serve as prospective markers of the functional outcome trajectory from 6 to 24\u00a0months post\u2010surgery, aiding in rehabilitation programming and return\u2010to\u2010sport decisions to improve surgical outcomes and reduce the risk of reinjury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level II.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07000-8","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T07:02:49Z","timestamp":1655276569000},"page":"1690-1698","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Early MRI\u2010based quantitative outcomes are associated with a positive functional performance trajectory from 6 to 24\u00a0months post\u2010ACL surgery"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0495-2626","authenticated-orcid":false,"given":"Sean W.","family":"Flannery","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics Warren Alpert Medical School of Brown University\/Rhode Island Hospital Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha M.","family":"Murray","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Orthopedic Surgery Boston Children\u2019s Hospital, Harvard Medical School 300 Longwood Ave 02115 Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary J.","family":"Badger","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Medical Biostatistics Larner College of Medicine, University of Vermont Burlington VT 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One or more of the authors has declared the following potential conflict of interest: MMM is a founder and equity holder in Miach Orthopaedics, Inc, which was formed to upscale production of the BEAR scaffold. MMM maintained a conflict-of-interest management plan that was approved by Boston Children\u2019s Hospital and Harvard Medical School during the conduct of the trial, with oversight by both conflict-of-interest committees and the institutional review board of Boston Children\u2019s Hospital, as well as the US Food and Drug Administration. AMK is a paid consultant of Miach Orthopaedics. DEK is a paid consultant for Miach Orthopaedics, Johnson & Johnson, and receives educational support from Kairos Surgical. BCF is an associate editor for The American Journal of Sports Medicine, a founder of Miach Orthopaedics, and the spouse of MMM who has the added conflicts. A conflict-of-interest management plan for BCF was implemented by Rhode Island Hospital during the course of this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Informed consent was obtained following IRB approval (IRB P00021470). Author contributions: SWF and GJB performed statistical analyses. AMK performed image processing. MMM, KE, DEK, and BEAR Trial Team designed and collected the BEAR clinical trial data. SWF, MMM, BCF, AMK conceived and designed the study. SWF, AMK and BCF drafted the manuscript. All authors read and approved the final manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}