title: Diagnostic accuracy of ACL tears according to tear morphology.
abstract: This retrospective analysis of 182 consecutive patients who underwent anterior cruciate ligament (ACL) reconstruction aimed to assess the clinical examination under anaesthetic and the MRI diagnostic accuracy of arthroscopically-proven, complete ACL ruptures, depending on the morphology of the torn ligament. Patients were then assigned to Group 1 (ACL not reattached) or Group 2 (ACL re-attached abnormally). Of 104 patients (57.1%) in Group 2, 94 (51.7%) had an abnormal re-attachment of the torn ACL to the posterior cruciate ligament (PCL). There was no significant difference between the groups on MRI reporting of a complete ACL tear (p = 0.123) and pivot shift test. On Lachman testing, more patients in Group 1 had an increased laxity compared with Group 2 (p = 0.014); similarly, more patients in Group 1 had an absent endpoint compared with Group 2 (p = 0.008). An ACL-deficient knee with an abnormal re-attachment of the torn ligament appears to be more difficult to diagnose than if there has been no re-attachment.
authors.affiliation: Ipswich Hospital, Ipswich, U.K. ajitdhillon@doctors.org.uk
authors.forename: Ajit K
authors.initials: AK
authors.lastname: Dhillon
authors.forename: Oday
authors.initials: O
authors.lastname: Al-Dadah
authors.forename: Christopher T J
authors.initials: CT
authors.lastname: Servant
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000473:pathology; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000473:pathology; D007718:Knee Injuries / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D012421:Rupture; D014945:Wound Healing