title: [CLINICAL AND ARTHROSCOPIC FINDINGS IN MENISCAL INJURY AND KNEE INSTABILITY: A PROSPECTIVE STUDY].
abstract: BACKGROUND
  Medical history and physical examination are expected to provide the basic knowledge allowing diagnosis of a disease and thus enabling to plan the course of treatment.
  
  
  OBJECTIVE
  This study aimed to examine this hypothesis by comparing pre-operative diagnosis of meniscal and anterior cruciate ligament (ACL) injuries to final surgical findings.
  
  
  METHODS
  We prospectively compared the pre-surgical diagnosis to the arthroscopic findings in 753 arthroscopic procedures.
  
  
  RESULTS
  Clinical diagnosis of a medial meniscal (MM) tear was proven by arthroscopy in 65% of cases. Clinical diagnosis of a lateral meniscal (LM) tear was proven by arthroscopy in 54% of cases. Clinical complaints of instability correlated with partial or complete ACL rupture in 85% of cases. The accuracy of the clinical examination concerning ACL integrity ranged from 86% to 90%. Lachman and Pivot tests were slightly superior to the Drawer test.
  
  
  CONCLUSIONS
  Arthroscopic surgery is the most common surgical procedure in orthopedics. The diagnosis, which is based on history and physical examination in most cases, allows proper management of the case and an appropriate treatment plan. In most scenarios, these operations are conducted based on the diagnosis and treatment performed before surgery. In this study we showed that even in experienced and skilled hands, a clinical diagnosis of meniscal tear was approved by arthroscopy in only 54% to 65% of cases. A clinical diagnosis of ACL injury was approved by arthroscopy, in 99% of cases.
  
  
  CONCLUSIONS
  When planning conservative treatment or surgical intervention for a knee injury, it should be kept in mind that the clinical diagnosis of ACL rupture is highly reliable, while the clinical diagnosis of meniscal injury is only moderately reliable. Thus, especially when planning surgical intervention, the utilization of further imaging would be desirable when isolated meniscal injury is suspected.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Palmanovich
authors.forename: Amir
authors.initials: A
authors.lastname: Manor
authors.forename: Iftach
authors.initials: I
authors.lastname: Hetsroni
authors.forename: Niv
authors.initials: N
authors.lastname: Marom
authors.forename: Alexander
authors.initials: A
authors.lastname: Finsterbush
authors.forename: Uri
authors.initials: U
authors.lastname: Frankl
authors.forename: Joseph
authors.initials: J
authors.lastname: Lowe
authors.forename: Gideon
authors.initials: G
authors.lastname: Mann
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D007718:Knee Injuries / Q000175:diagnosis / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008592:Menisci, Tibial / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D010347:Patient Care Planning; D018579:Patient Selection; D010808:Physical Examination / Q000379:methods / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013223:Statistics as Topic; D000070600:Tibial Meniscus Injuries