title: Diagnostic efficacy of standard knee magnetic resonance imaging and radiography in evaluating integrity of anterior cruciate ligament before unicompartmental knee arthroplasty.
abstract: OBJECTIVE
  The purpose of this study was to investigate the diagnostic efficacy of standard magnetic resonance imaging (MRI) and plain radiographs in determining the status of anterior cruciate ligament (ACL) for surgical decision-making processes in cases of medial unicompartmental knee arthroplasty (UKA).
  
  
  METHODS
  A total of 59 knees of 36 consecutive patients who underwent knee replacement surgery were analyzed retrospectively. MRI scans were assessed independently by 3 observers (radiologists), while the plain radiographs were evaluated by an independent radiologist. Results were compared with the intraoperative ACL status. Cross tabulation was used for descriptive statistics to analyze sensitivity, specificity, and accuracy of MRI and plain radiographs.
  
  
  RESULTS
  When the same observer assessed and classified the MRI twice, the reproducibility of the classification system varied from moderate to excellent. However, the interobserver concordance was moderate. The sensitivity of MRI was 73% and the specificity was 81%, while the sensitivity and specificity of plain radiographs was 36% and 79%, respectively. The accuracy of MRI was 80%, while that of the radiographs was 71%.
  
  
  CONCLUSIONS
  Detection of intact ACL may be possible on available plain radiographs without necessity for additional means such as MRI, which may cause increase costs and loss of time. In cases where there is uncertainty regarding ACL integrity in degenerative knees, although standard MRI provides additional information on ACL status, it is not of sufficient diagnostic value.
authors.affiliation: Akdeniz University Faculty of Medicine, Department of Orthopedics and Traumatology, Antalya, Turkey. leventaltinel@yahoo.com.
authors.forename: Levent
authors.initials: L
authors.lastname: Altınel
authors.affiliation: Akdeniz University Faculty of Medicine, Department of Orthopedics and Traumatology, Antalya, Turkey.
authors.forename: Mehmet Serhan
authors.initials: MS
authors.lastname: Er
authors.affiliation: Afyon Kocatepe University Faculty of Medicine, Department of Radiology, Afyon, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Kaçar
authors.affiliation: Afyon Kocatepe University Faculty of Medicine, Department of Orthopedics and Traumatology, Afyon, Turkey.
authors.forename: Recep Abdullah
authors.initials: RA
authors.lastname: Erten
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis*; D011859:Radiography; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity