Insuficiencia del ligamento cruzado anterior. Valor diagnóstico de la exploración clinica y RM

Abstract

Objective The clinical diagnosis of anterior cruciate ligament (ACL) failure uses subjective criteria and its sensitivity is low. Magnetic resonance imaging (MRI) has become the standard in the non-invasive evaluation of knee injuries. It is important to determine the diagnosis by clinical examination (CE) and MR versus the arthroscopy pattern in the ACL injuries, and to know and specify their objective exploratory parameters. Materials and Methods A total of 101 medical records were reviewed: CE-radiological suspicion of ACL failure, examination using a subjective/objective test protocol, MR, objective CE under anaesthesia and diagnostic/therapeutic arthroscopy. We selected epidemiological data, times from the ACL to surgery, previous operation on the affected knee, subjective data, objective data including arthrometry, number of centres that performed MR, the number of MR per centre, observations and arthroscopy. Results A statistical study was performed comparing quantitative and qualitative variables, precision, reliability and consistency between actions. A total of 94%, 100% and 83% were diagnosed using EC without anaesthesia, with anaesthesia and MR, with a sensitivity of 94.06%, 100% and 83.17%, respectively. Discussion The CE with/without-anaesthesia, diagnosed ACL failure more often than MR. MR diagnoses the total number of concomitant injuries and detects more external meniscus injuries. The Lachman test and arthrometry are the most significant diagnostic methods in ACL failure.