Combined anterior and rotational knee laxity measurements improve the diagnosis of anterior cruciate ligament injuries.
Knee Surg Sports Traumatol Arthrosc
; 23(10): 2859-67, 2015 Oct.
Article
em En
| MEDLINE
| ID: mdl-26318487
ABSTRACT
PURPOSE:
This study analysed whether associating the side-to-side difference in displacement and the slope of the load-displacement curve of anterior and rotational knee laxity measurements would improve the instrumental diagnosis of anterior cruciate ligament (ACL) ruptures and help to detect different types of ACL tears.METHODS:
Anterior and rotational knee laxity was measured in 128 patients with an arthroscopically confirmed ACL injury and 104 healthy controls. Side-to-side differences were determined for three variables in anterior laxity anterior displacement at 200 N (ATD200), primary compliance from 30 to 50 N (PCA) and secondary compliance from 100 to 200 N (SCA). Furthermore, four variables in rotational laxity were considered internal and external rotation at 5 N m (IR5/ER5) and compliance from 2 to 5 N m (C IR/C ER). Receiver operating characteristic curves allowed to determine thresholds, specificities and sensitivities to detect ACL lesions, based on single variables considered and combinations thereof.RESULTS:
Sensitivity and specificity reached, respectively, 75 and 95 % for ATD200 (threshold 1.2 mm) and 38 and 95 % for IR5 (threshold 3.2°). If either two out of the three variables were positive for anterior laxity or both IR5 and C IR were positive, 81 % of patients were identified without a false positive. All patients for whom ATD200 was >3.7 mm, PCA > 48 µm/N or SCA > 17.5 µm/N had ACL remnants that were either totally resorbed or healed on the posterior cruciate ligament.CONCLUSION:
Combined instrumented anterior and rotational knee laxity measurements have excellent diagnostic value for ACL injury, provided that several measurements be considered concomitantly. LEVEL OF EVIDENCE Diagnostic study, Level III.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrometria Articular
/
Lesões do Ligamento Cruzado Anterior
/
Instabilidade Articular
/
Traumatismos do Joelho
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Knee Surg Sports Traumatol Arthrosc
Ano de publicação:
2015
Tipo de documento:
Article