Cruciate Ligament Injuries Of Knee Research Articles

Diagnostic value of 3D fast spin-echo sequence scanning combined with multislice spiral CT in knee cruciate ligament injury

To explore the potential value of three-dimensional fast spin echo（3D-SPACE） combined with multilayer spiral CT （MSCT） in the diagnosis of knee cruciate ligament injury, to provide a new direction for the optimization of subsequent clinical diagnosis. A total of 120 patients with knee cruciate ligament injury were treated from April 2020 to April 2021, aged from 21 to 68 with an average of（41.52±4.13） years old. For all patients, separate MSCT scanner scans, 3D-SPACE sequence scans alone and 3D-SPACE sequence combined with MSCT scans were used. The injury and classification of the anterior and posterior cruciate ligament of the knee were compared, the length of the anterior-medial bundle and posterolateral bundle and its angle of the knee with the horizontal plane were observed, the diagnostic value of 3 diagnostic methods in knee cruciate ligament injury were determined. There was no significant difference between the 3D-SPACE sequence scan alone and the MSCT test alone on the total diagnostic rate and grading total diagnostic rate（P>0.05）. The total diagnostic rate and grading total diagnostic rate of 3D-SPACE scan combined with MSCT were significantly higher than those of 3D-SPACE scan or MSCT alone（P<0.05）. The 3D-SPACE sequence scan alone and the MSCT detection alone had no significant difference in the measurement values related to the anterior and posterior cruciate ligaments of the knee joint（P>0.05）. 3D-SPACE sequence scanning combined with MSCT detection on the knee joint anterior and posterior cruciate ligament related measurements were significantly higher than the 3D-SPACE sequence scan or MSCT detection alone（P<0.05）. The area under the ROC curve estimated by 3D-SPACE sequence scanning combined with MSCT was 0.960, which was significantly higher than that of 3D-SPACE sequence scanning and MSCT alone evaluating the area under the ROC curve line of 0.756 and 0.795. The combined 3D-SPACE sequence scanning and 3D-SPACE sequence scanning MSCT analysis and prediction models were statistically different（Z=2.236, P<0.05）, and MSCT alone and 3D-SPACE sequence scanning combined with MSCT analysis and prediction models were statistically different（Z=2.653, P<0.05）. The application of 3D-SPACE sequence combined with MSCT scanning for knee cruciate ligament injury can improve the diagnosis rate of patients with knee cruciate ligament injury.It can be used as a diagnostic tool for patients with knee cruciate ligament injury and is worthy of clinical application.

Correlation of clinical, radiological and arthroscopic findings of meniscal and anterior cruciate ligament injuries of knee

Background: Orthopaedic surgeons commonly see soft tissue injuries of the knee including meniscal and ligament injuries. In the past diagnosis of these injuries was based on accurate clinical examination alone as plain radiographs were unable to detect these soft tissue injuries. Clinical examination alone produced false diagnosis rates between 40-85%. Aim of the study was to correlate clinical, radiological and arthroscopic findings of meniscal and anterior cruciate ligament injuries of knee. Methods: A Prospective observational study was conducted for a period of two year and all patients admitted to Manipal hospital who were scheduled to undergo arthroscopic surgery of the knee for either meniscal or ACL injury based on clinical and Magnetic Resonance Imaging (MRI) findings were included in the study. Results: 65 patients were studied comparing clinical examination, MRI with arthroscopy and were analyzed. Clinical examination showed sensitivity, specificity, Positive Predictive value (PPV), Negative Predictive value (NPV), accuracy of 76.47%,48.65%, 52.50%, 93.72%, 60% respectively for medial meniscus tear, 84.62%, 100%, 100%, 96.30%, 96.92% respectively for lateral meniscus tear and 76.47%, 87.50%, 68.42%, 91.30%, 84.62% respectively for Anterior Cruciate Ligament (ACL) tear. MRI findings showed sensitivity, specificity PPV, NPV, accuracy of 92.86%, 81.08%, 78.79%, 93.75%, 86.1% respectively for medial meniscus, 92.31%, 100%, 100%, 98.11%, 98.46% respectively for lateral meniscus tear, 82.35%, 91.67%, 77.78%, 93.62%, 89.23% respectively for ACL tear. Conclusion: Clinical tests to detect ACL and lateral meniscus injuries have a high degree of correlation when compared to arthroscopy and MRI. Clinical tests to detect medial meniscus injuries have a lower degree of correlation compared to MRI and arthroscopy.

MRI and Arthroscopic Correlation in Anterior Cruciate Ligament Injuries of Knee

MRI and Arthroscopic Correlation in Anterior Cruciate Ligament Injuries of Knee

High field 3T magnetic resonance imaging: MR-anatomy evaluation of traumatic knee injuries

Background: MRI has high applicability to the knees, in comparison with other joints, and it provides excellent diagnostic capacity for evaluating lesions of different types, such as ligament, meniscal, tendon, bone and chondral injuries. MR imaging does not utilize ionizing radiation and therefore it is entirely safe; it is also noninvasive, painless, and allows acquisition of images in multiple planes without repositioning the patient. In addition, MR provides excellent spatial and contrast resolution of both intra- and extra-articular structures. Objective: The purpose of the study was to review the normal MR anatomy of the internal structures of knee joint and to study MRI appearances of various meniscal and cruciate ligament injuries of knee. Results: Knee injuries were more commonly encountered in males as compared to females. ACL was the most commonly injured ligament followed by tears of the menisci. Medial meniscal tears were twice as common as lateral meniscal tears. Vertical and complex tears are slightly more common than horizontal tears, which were predominantly seen in elderly population bearing degenerative changes. PCL tears and tears of the collateral ligaments were rare. Conclusion: Magnetic resonance imaging is a good, accurate and non-invasive modality for the assessment of menisci and ligamenteous injuries. High field 3 T MRI is unique in its ability to evaluate the internal structures of knee with exquisite detail. MRI is highly accurate in the diagnosis of tears of the menisci and cruciate ligaments and thus, it is increasingly used as a first line investigation in patients with soft tissue trauma to knee.

A Seated Single-Person Dial-Test for Posterolateral Corner and Posterior Cruciate Ligament Knee Injuries

Background: Injuries to the posterolateral corner of the knee (PLC) can be difficult to diagnose and are often missed. The prone dial test can be difficult to perform in the acute setting and the supine dial test requires an assistant. Purpose: We present a simple single person seated dial test that can easily be performed in all patients with a suspected diagnosis of PLC injury. Study Design: Case Series. Method: The patient is seated on the edge of the examination couch with their knees flexed over the side and their calves pressed against the couch to reduce any posterior tibial subluxation. The patients’ knees are placed together ensuring the pelvis is square; the knees are at the same level, and the patellae are facing anteriorly. The patients place their hands against the side of their knees and hold their knees together in this position. The examiner then grasps the patient’s feet, approximates the medial malleoli and exerts a lateral rotational force at 30 and 90 degrees of knee flexion. Results: This test has 100% accuracy for diagnosing PLC injury in our institution. Conclusion: We present a sample to use alternative to traditional dial testing that does not require an assistant and also does not require the patient to be prone, thus limiting discomfort in the acute setting.