The Location of Anterior Cruciate Ligament Tears: A Prevalence Study Using Magnetic Resonance Imaging (original) (raw)
Related papers
Role of Age on Success of Arthroscopic Primary Repair of Proximal Anterior Cruciate Ligament Tears
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2021
To assess failure rates and patient-reported outcomes measures (PROMs) following arthroscopic primary ACL repair of proximal tears in different age groups. Methods: Between 2008 and 2017, the first 113 consecutive patients treated with repair were retrospectively reviewed at minimum of 2-years. Patients were stratified into three age groups: ≤21, 22-35, and >35 years. Primary outcomes were ipsilateral reinjury or reoperation, and contralateral injury rates, and secondary outcomes consisted of Lysholm, modified Cincinnati, Single Assessment Numeric Evaluation (SANE), International Knee Documentation Committee (IKDC) subjective, pain, and satisfaction scores. Group differences were compared using chisquare tests and Mann-Whitney U tests. Results: Follow-up was obtained in 113 patients (100%). Median age was 35 years (IQR 23-43) and median follow-up was 2.2 years (IQR 2.0-2.8). Overall, ACL reinjury occurred in 13 patients (11.5%), reoperation in seven patients (6.2%), complications in two patients (1.8%) and contralateral ACL injury in four patients (3.5%). Overall, median Lysholm was 95 (IQR 89-100) and IKDC subjective 92 (IQR 84-99). Treatment failure was significantly higher in the youngest age group (37.0%) as compared to the middle and older groups (4.2% and 3.2%, both p<0.005). No significant differences were seen in reoperation, complication, or contralateral injury rates between groups (all p>0.2), nor in PROMs between the groups (all p>0.1). Conclusion: The failure rate of primary repair of proximal ACL tears is high in patients aged 21 or younger (37.0%), and this should be taken into account when discussing repair in this patient group. In patients older than 21, repair may be an excellent treatment with low failure (3.5%) and complication rates (1.2%) and good subjective scores.
Orthopaedic Journal of Sports Medicine
Background: Partial anterior cruciate ligament (ACL) tears are observed in 10% to 27% of isolated ACL tears. There is currently no consensus on diagnosis and treatment protocols, and the outcomes of nonoperative treatment remain undefined. Purpose: To assess the incidence and risk factors for the progression of partial ACL tears to complete ruptures after nonoperative treatment in active patients younger than 30 years. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 41 patients, all younger than 30 years and active in sports, were diagnosed with a partial ACL tear, with no associated meniscal or chondral lesions on magnetic resonance imaging (MRI). All were assigned to a nonoperative treatment program. The Lachman test, ≤4-mm side-to-side difference in laxity by Rolimeter, and MRI were utilized for the diagnosis. Tegner and International Knee Documentation Committee (IKDC) scores were assessed before and after the first lesion, and the Anterior Cruciate L...
Diagnostic assessment in anterior cruciate ligament (ACL) tears
Prilozi, 2014
The aim of this study was to compare findings from clinical examinations, MRI scans and arthroscopy in ACL injury of the knee in order to assess the diagnostic significance of both examination findings. This study was conducted to manage the reliability of clinical diagnosis in ACL tear injuries. All patients attending our clinic with knee pain from 2009 to 2013 underwent systematic and thorough clinical assessment. Of 103 patients with knee problems arthroscopy ACL tears was diagnosed in 73. All these patients underwent therapeutic arthroscopic knee surgery. The clinical diagnosis was evaluated and confirmed during this procedure. The accuracy, sensitivity and specificity were calculated based on these arthroscopic findings. The MRI accuracy of clinical diagnosis in our study was 82.5% for ACL tears. Accuracy for two of three clinical examination tests of clinical diagnosis in our study was 96% and 94% for ACL tears. According to our obtained correlation between clinical examinatio...
The Journal of bone and joint surgery. British volume, 1995
We reviewed 38 patients with arthroscopically-proven complete ACL tears operated on less than three weeks after injury. Their average age was 26 years (16 to 43), with 27 males and 11 females. All patients had had MRI preoperatively. The same examiner performed the Lachman, anterior-drawer, and pivot-shift tests without anaesthesia, recording the differences between the injured and the normal knees. The patients then had KT-1000 arthrometry by the same examiner at 15 lb (6.8 kg) and 20 lb (9 kg), with active displacement, and with maximum manual displacement. All scored positive for differences greater than 3 mm. The results of physical examination, KT-1000 tests and MRI were analysed using McNemar's test for matched data with continuity correction and a 95% confidence interval for each test. The sensitivity of the KT-1000 manual maximum test was 97% for 3 mm and 100% for 2 mm; this was the most useful arthrometric result. The Lachman test gave 95% sensitivity, providing the bes...
The healing potential of an acutely repaired ACL: a sequential MRI study
Journal of Orthopaedics and Traumatology, 2020
Background Recently, there has been renewed interest in primary anterior cruciate ligament (ACL) repair. The aim of this study is to report early clinical and radiological results of a consecutive series of acute ACL tears treated with arthroscopic primary ACL repair within 14 days from injury. Patients and methods A consecutive series of patients with acute ACL tears were prospectively included in the study. Based on MRI appearance, ACL tears were classified into five types, and tissue quality was graded as good, fair, and poor. Patients with type I, II, and III tears and at least 50% of ACL tibial remnant intact with good tissue quality were ultimately included. Clinical outcomes were measured using the Tegner Lysholm Knee Scoring Scale (TLKSS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), subjective and objective International Knee Documentation Committee (IKDC) scores, and KT-1000. Patients were also followed up with MRI evaluations at 1, 3, and 6 months postoperativ...
Natural history of partial anterior cruciate ligament tears: a systematic literature review
Orthopaedics & traumatology, surgery & research : OTSR, 2012
Partial anterior cruciate ligament (ACL) tear is frequent, and indications for surgery may be raised by a diagnostic aspect associating slight laxity with no clear pivot-shift. Unlike that of complete ACL tear, the natural history of partial tear remains controversial. A systematic literature review searched for referenced publications on the natural history of partial ACL tear. Twelve specific articles were retrieved. Initial diagnosis was systematically confirmed on arthroscopy, without ACL surgery. The following criteria were analyzed: firstly, preoperative: confirmation of inclusion criteria, preoperative clinical data, follow-up, arthroscopic lesion assessment, Lachman test, Pivot shift test, hemarthrosis, associated lesions and secondly, follow-up: Lachman test, Pivot shift test, revision surgery, functional clinical scores, pain, sport and return to sport, meniscal events. Preoperatively, Lachman tests were positive (soft or delayed) in a mean 49.7% of cases (range, 0-100%); ...
Does anterolateral ligament injury change the treatment option in patients with partial ACL tears?
Acta orthopaedica Belgica, 2021
Patients with ACL tears with ALL injury have more clinical complaints (instability, feeling of the pop on the knee or knee sliding). patients have ALL injury with partial ACL tears, It is unclear whether the choice of treatment will be conservative or surgical. This study aimed to determine the effect of anterolateral ligament (ALL) status, whether intact or ruptured, on the choice of conservative or surgical treatment in patients with partial anterior cruciate ligament (ACL) tears. Between 2015 and 2019, patients with suspected partial ACL tears were identified on both physical examination and MR imaging. 122 patients who had partial ACL tears and also status of patient's ALL could be evaluated by radiologist were included in the study, retrospectively. Sixty-two patients who underwent ACL reconstruction were determined as group 1, and 60 patients who did not undergo ACL reconstruction were defined as group 2. In patients with partial ACL rupture with or without ACL reconstruct...
Arthroscopy, 2018
Purpose: To assess the midterm clinical outcomes in patients with proximal avulsion anterior cruciate ligament (ACL) tears undergoing arthroscopic primary repair with suture anchors. Methods: The first 11 consecutive patients with proximal avulsion tears treated with arthroscopic primary repair were evaluated at midterm (minimum 5-year) follow-up. Physical examination was performed; laxity examination consisting of the Lachman, pivot-shift, and anterior drawer tests was performed; and patients were asked to complete the Lysholm, modified Cincinnati, Single Assessment Numeric Evaluation, and International Knee Documentation Committee (IKDC) questionnaires. Results: Of the 11 patients, 10 were seen at a mean follow-up of 6.0 AE 1.5 years (range, 4.8-9.2 years). One patient was lost to follow-up, in whom failure had already occurred at short-term follow-up. One additional patient underwent reoperation for a medial meniscus tear and also had a partial ACL tear; this patient was clinically stable at last follow-up. All patients had full range of motion. Nine patients had negative Lachman and negative pivot-shift examination findings (IKDC score of A), and 1 patient had a 1A Lachman result and 1þ pivot-shift result (IKDC score of B). The mean Lysholm score was 96.0 AE 4.5 (range, 88-100); modified Cincinnati score, 95.6 AE 7.4 (range, 80-100); Single Assessment Numeric Evaluation score, 95.4 AE 5.4 (range, 85-100); preinjury Tegner score, 7.2 AE 1.2 (range, 5-9); postoperative Tegner score, 6.6 AE 1.8 (range, 3-9); and IKDC subjective score, 92.3 AE 11.3 (range, 64-100). Conclusions: The clinical outcomes of arthroscopic primary repair of proximal ACL tears with suture anchors are excellent and are maintained at midterm follow-up in a carefully selected subset of patients with proximal tears and excellent tissue quality. Level of Evidence: Level IV, therapeutic case series.