scholarly journals Diagnostic accuracy of dynamic ultrasound imaging in partial and complete anterior cruciate ligament tears: a retrospective study in 247 patients

2019 ◽  
Vol 5 (1) ◽  
pp. e000605 ◽  
Author(s):  
Manon Breukers ◽  
Dorieke Haase ◽  
Stephan Konijnenberg ◽  
Tiburtius V S Klos ◽  
Geert-Jan Dinant ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Point Of Care ◽  
Cruciate Ligament ◽  
Multivariate Regression Analysis ◽  
Point Of Care Test ◽  
Dynamic Ultrasound ◽  
Anterior Cruciate ◽  
Knee Pathology

ObjectivesDynamic ultrasound (US) imaging shows promising possibilities for accurate imaging in diagnosing anterior cruciate ligament (ACL) tears and can be used as a point-of-care test. The aim of this study is to determine the diagnostic accuracy of dynamic US imaging for detecting partial and complete ACL tears.Methods247 patients presenting with knee complaints, who underwent dynamic US imaging as well as arthroscopy for any intra-articular knee pathology, were retrospectively evaluated. We differentiated between partial and complete ACL tears.ResultsDynamic US imaging revealed 95 of 108 arthroscopically confirmed ACL tears (sensitivity 88%, specificity 82%, positive predictive value (PPV) 79%, negative predictive value (NPV) 90%, and diagnostic OR (DOR) of 33.3). Sensitivity of US in the detection of partial ACL tears was 52%, specificity 85%, PPV 52%, NPV 84% and DOR 5.8. Complete ACL tears were depicted with a sensitivity of 79%, specificity of 89%, PPV of 63%, NPV of 95% and DOR 29.8. Multivariate regression analysis adjusting for age (dichotomised per 5 years) and previous knee surgery showed similar DOR.ConclusionThe excellent NPV for complete ACL tears indicates that dynamic US imaging can be used as an initial imaging point-of-care test. However, the clinical presentation should be taken into account, especially in case of subtotal tears. Whereas it seems relatively easy to differentiate between (small) partial ACL tears, complete ACL tears and no tears, it seems to be difficult to differentiate subtotal tears from complete tears.

scholarly journals Diagnostic accuracy of magnetic resonance imaging in detecting anterior cruciate ligament injuries

2017 ◽  
Vol 26 (3) ◽  
pp. 218-23
Author(s):  
Ashfaq Ahmed ◽  
Muhammad A. Razzaque ◽  
Muhammad Kaleem ◽  
Atiq U. Zaman ◽  
Rizwan Akram ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Resonance Imaging ◽  
Anterior Cruciate

Background: The anterior cruciate ligament (ACL) stabilizes the joint during hyperextension and prevents anterior translation over femur. The objective of this study was to determine the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting ACL injury by taking arthroscopy as gold standard in patients with traumatic knee injury.Methods: Patients fulfilling the study criteria were treated with clinical examination, MRI and then arthroscopy at the Department of Orthopedics and Spine in the Ghurki Trust Teaching Hospital, Lahore. The accuracy, sensitivity and specificity of MRI in diagnosing  the anterior cruciate ligament injury were calculated based on arthroscopic findings. All the data were analyzed using SPSS 17.0 version.Results: A total 185 patients were included. 91.1% were males and 8.9% were females with Mean age of 28.25±0.433. The accuracy of MRI in diagnosing the anterior cruciate ligament was 91.89%, with sensitivity of 93.33%, specificity of 85.71%, positive predictive value of 96.55% and the negative predictive value  of 75%.Conclusion: MRI is accurate and non-invasive modality for the assessment of ligamentous injuries. It can be used as a first line investigation to patients with suspicion of ACL injury.

scholarly journals Anterior Cruciate Ligament Injury

2014 ◽  
Vol 2 (12_suppl4) ◽  
pp. 2325967114S0025
Author(s):  
Tomas Vilaseca ◽  
Jorge Chahla ◽  
Gustavo Gomez Rodriguez ◽  
Damián Arroquy ◽  
Gonzalo Perez Herrera ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Internal Rotation ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
T Test ◽  
Control Group ◽  
Recreational Athletes ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Knee Pathology

Objectives: The objective of this study was to analyze whether it is more frequent the presence of a decreased range of motion in the hips of recreational athletes with primary injury of the anterior cruciate ligament (ACL) than in a control group of volunteers without knee pathology. Methods: We included prospectively recreational athletes between 18 and 40 years with an acute ACL injury between January 2011 and January 2013. They were compared with a control group of volunteers recreational athletes without lower limb pathology and in the same range of age. The internal and external rotations passively prior to the point at which the pelvis movement contributes were observed. The results were statistically analyzed using t test for related samples to the hips of patients with ACL injury and t test for independent variables for comparison with the control group. Results: 48 patients with ACL injury and 53 healthy volunteers were evaluated. The ACL group was composed of 32 males and 16 females with an average age of 29.3 years. In the control group 26 males and 27 females were studied with a mean age of 26.6 years. Internal (IR) and external (ER) rotation in the LCA group was 22,9º and 55,5º respectively in the ipsilateral hip and 27,9º and 57,7º in the contralateral. In the control group a 35,9º of IR and 55,2º of ER was observed. The analysis showed an association between ACL injury and hypomotility of the hip further expense of a decrease in internal rotation. The analysis showed an association between ACL injury and hypomotility of the hip at the expense to a greater decrease in internal rotation. Conclusion: We found a statistically significant difference in the mobility of the hips in patients with ACL injury predominantly due to internal rotation, pattern that allows us to interpret this injury not only as an intrinsic etiology of the knee but also of the adjacent joints. We consider very importance to incorporate prevention activities and screening of risk factors regarding to at least high performance athletes.

scholarly journals Accuracy of Magnetic Resonance Imaging in Diagnosis of Internal Derangement of the Knee

2016 ◽  
Vol 23 (4) ◽  
pp. 11-17 ◽  
Author(s):  
Mohammad M. Abbas ◽  
Abdullah A. Abulaban ◽  
Mamdooh M. Kotb
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Anterior Cruciate Ligament Injuries ◽  
Preoperative Magnetic Resonance ◽  
Anterior Cruciate ◽  
Operative Notes ◽  
Knee Pathology

The current study aims to assess the sensitivity and specifi city of magnetic resonance imaging by reference to arthroscopy in the preoperative diagnosis of knee pathologies. In this retrospective study, pre-operative knee magnetic resonance imaging reports of 70 patients were reviewed by a blinded musculoskeletal radiologist and compared with the respective arthroscopic fi ndings recorded in the operative notes. Pre-operative magnetic resonance imaging demonstrated a sensitivity level of 92.7% and 61.3% and specifi city level of 33.3% and 53.9% in detecting pathologies of the medial and lateral menisci, respectively. With respect to the cases of complete anterior cruciate ligament tear, sensitivity was 76.7% with 92.5% specifi city. On the other hand, magnetic resonance imaging demonstrated 100% sensitivity and 90.7% specifi city in the diagnosis of posterior cruciate ligament partial tear. Relatively better sensitivity in detecting cruciate ligaments pathology and better specifi city in detecting menisci pathology was reported using magnetic resonance imaging. Almost 25% of complete anterior cruciate ligament injuries may remain undetected in preoperative magnetic resonance imaging reports, while they represent the most prevalent knee injury. Magnetic resonance imaging should be used with caution in knee pathology and arthroscopy continues to be the gold standard.

Preoperative Ultrasonographic Prediction of Hamstring Tendon Diameter for Anterior Cruciate Ligament Repair

2016 ◽  
Vol 30 (06) ◽  
pp. 544-548 ◽  
Author(s):  
Luis Rodriguez-Mendez ◽  
Jose Martinez-Ruiz ◽  
Ruben Perez-Manzo ◽  
Jorge Corona-Hernandez ◽  
Juan Alcala-Zermeno ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Acl Injuries ◽  
Minimum Diameter ◽  
The Mean ◽  
Anterior Cruciate ◽  
Grafting Procedure

AbstractThe incidence of anterior cruciate ligament (ACL) injuries is rising every year. The autologous hamstring tendon graft, using semitendinosus tendon (SMT) and gracilis tendon (GR), is a common repair technique in the management of ACL injuries due to its multiple advantages. Using a final graft with a minimum diameter of 8 mm is necessary to avoid graft failure. The aim of this study was to find a correlation between preoperative ultrasound (USG) measurement of the SMT and GR tendon diameters (SMTd and GRd) and their actual diameters measured during the grafting procedure. In the present study, 33 male patients aged between 16 and 43 years with ACL injury that required grafting were enrolled. Before the grafting procedure, we sonographically measured the SMTd, GRd, and calculated the hamstring tendon diameter (SMTd + GRd) as the sum of these two. During surgery, we obtained the SMTd, GRd, and SMTd + GRd; we also obtained the length of both tendons and the final graft diameter (FGd). We then compared the obtained values. Mean age was 25.6 ± 7.9 years in our study population. The mean SMTd, GRd, and SMTd + GRd obtained by USG versus transoperatively were 4.9 versus 4.7 mm, 4.3 versus 3.8 mm, and 9.3 versus 8.6 mm, respectively. The mean of FGd was 8.4 mm and the mean length of both tendons was 14.2 cm. The GRd obtained by USG positively correlated with SMTd, SMT tendon length, GRd, and SMTd + GRd (r = 0.460, 0.404, 0.411, and 0.508, respectively). USG-obtained GRd predicts a final tendon diameter < 8 mm (high risk of failure) with a sensitivity, specificity, positive predictive value, and negative predictive value of 100, 54, 28 and 100%, respectively, using 4.5 mm as cutoff. Of all obtained grafts, 85% were deemed adequate (≥ 8 mm) using transoperative measurement, while 91% were ≥ 8 mm using USG measurement. The USG measurement of hamstring tendons is a useful method to predict their transoperative diameter. GRd obtained by USG is the best predictor of transoperative GRd and SMTd + GRd.

Arthrometric Evaluation of Posterior Cruciate Ligament Injuries

1998 ◽  
Vol 26 (1) ◽  
pp. 96-102 ◽  
Author(s):  
Colin L. Eakin ◽  
W. Dilworth Cannon
Keyword(s):  
Anterior Cruciate Ligament ◽  
Posterior Cruciate Ligament ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Posterior Cruciate Ligament Injury ◽  
Ligament Injuries ◽  
Posterior Translation ◽  
Anterior Cruciate ◽  
Anterior Posterior

We reviewed the clinical examinations and knee arthrometry evaluations of 40 patients: 10 with posterior cruciate ligament injuries, 10 with combination anterior and posterior cruciate ligament injuries, 10 with anterior cruciate ligament injuries alone, and 10 with no history of knee injury. Using a 3-mm side-to-side difference as the minimal limit for detection of posterior cruciate ligament injury, the sensitivity of the arthrometer at 40 pounds of posterior force was 90%, the specificity was 100%, the predictive value of a positive test was 100%, and the predictive value of a negative test was 91%. When total anterior-posterior translation was assessed, the sensitivity was 100%, the specificity was 85%, the predictive value of a positive test was 87%, and the predictive value of a negative test was 100%. The overall accuracy of arthrometry for detection of posterior cruciate ligament injury was 96% for 40 pounds of posterior force and 94% for total anterior-posterior translation at 40 pounds. Grade 1 posterior cruciate ligament injuries had significantly greater arthrometric posterior translation compared with grade 0 (normal) knees. Regression analysis showed arthrometric laxity measurements correlated well with the clinical grade of the posterior drawer test. Finally, the accuracy of the arthrometer was not affected by concomitant anterior cruciate ligament injury.

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