Evaluation of the Clinical Examinations in Diagnosis of Anterior Cruciate Ligament(ACL)Tear in Comparison With A Definite Arthroscopic Diagnosis
Iraqi Postgraduate Medical Journal,
2007, Volume 6, Issue 3, Pages 194-197
The cruciate ligaments consists of a pair of very strong ligaments, connecting tibia to femur crossing like the limbs of letter X and that is why they are called crucial, mostly injured in noncontact sport actions leading to knee instability.
AIM OF THE STUDY:
To determine the accuracy of the clinical approach in the diagnosis of ACL tear. We used diagnostic arthroscopy as a reference standard for evaluating our results by applying it to all the patients.
During the period from Dec-2000 to Oct-2002, we led a prospective study of 72 patients with suspected ACL tear, depending on careful history & physical examination, then confirmed by direct arthroscopy.
We found that only 52 patients have got ACL tear, 49 of them (94%) were males & 3 (6%) were females. The age range was from 17-49 years, with a mean of 27.5 years, 42% of the patients had associated meniscal injuries. The commonest symptom was a heard pop, & the main sign detected was knee joint effusion due to haemarthrosis.
The accuracies of Lachman test, Anterior Drawer Test & Pivot Shift T. were 94%, 82% & 58%
respectively, all were improved under G.A., particularly the PST.
Most of ACL tears can be diagnosed by thorough history& repeated clinical examination only, considering arthroscopy as a last but a definite choice.
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