A review of ultrasonographic methods for the assessment of the anterior cruciate ligament in patients with knee instability - diagnostics using a posterior approach.
OBJECTIVE
The purpose of the study was to improve the ultrasonographic assessment of the anterior cruciate ligament by an inclusion of a dynamic element. The proposed functional modification aims to restore normal posterior cruciate ligament tension, which is associated with a visible change in the ligament shape. This method reduces the risk of an error resulting from subjectively assessing the shape of the posterior cruciate ligament. It should be also emphasized that the method combined with other ultrasound anterior cruciate ligament assessment techniques helps increase diagnostic accuracy.


METHODS
Ultrasonography is used as an adjunctive technique in the diagnosis of anterior cruciate ligament injury. The paper presents a sonographic technique for the assessment of suspected anterior cruciate ligament insufficiency supplemented by the use of a dynamic examination. This technique can be recommended as an additional procedure in routine ultrasound diagnostics of anterior cruciate ligament injuries.


RESULTS
Supplementing routine ultrasonography with the dynamic assessment of posterior cruciate ligament shape changes in patients with suspected anterior cruciate ligament injury reduces the risk of subjective errors and increases diagnostic accuracy. This is important especially in cases of minor anterior knee instability and bilateral anterior knee instability.


CONCLUSIONS
An assessment of changes in posterior cruciate ligament using a dynamic ultrasound examination effectively complements routine sonographic diagnostic techniques for anterior cruciate ligament insufficiency.
Department of Orthopedic Surgery, Surgery Clinic, Medicover Hospital, Warsaw, Poland.
Tomasz
T
Poboży
Department of Oncology and Nursing Oncology, Institute of Nursing and Obstetrics, Faculty of Medicine and Health Science, The Jan Kochanowski University in Kielce, Poland; I Chair and Clinic of General and Vascular Surgery, II Faculty of Medicine with the English Division Medical University of Warsaw, Poland.
Maciej
M
Kielar
anterior cruciate ligament; anterior knee instability; knee ultrasound; posterior cruciate ligament; ultrasonography; ultrasound ligament assessment
J Clin Ultrasound. 2004 Nov-Dec;32(9):481-90
15558615
AJR Am J Roentgenol. 1995 Jun;164(6):1461-3
7754893
Arch Orthop Trauma Surg. 1991;110(4):200-3
1892715
Eur J Radiol. 2007 Apr;62(1):44-67
17344010
Eur J Ultrasound. 2000 Dec;12 (2):163-7
11118925
Acta Orthop Belg. 2006 Jan;72 (1):72-6
16570898
Pol Merkur Lekarski. 2006 Jul;21(121):41-3
17007291
Eur J Ultrasound. 2001 Oct;14 (1):57-71
11567855
Indian J Orthop. 2015 Mar-Apr;49(2):143-9
26015601
Knee. 2009 Dec;16(6):441-6
19464900
Gac Med Mex. 2014 Dec;150 Suppl 2:259-65
25643788
Am J Sports Med. 1991 Sep-Oct;19(5):474-7
1962712
AJR Am J Roentgenol. 2009 Sep;193(3):619-27
19696273
Am J Sports Med. 1985 Jan-Feb;13(1):5-10
3976980
Arch Orthop Trauma Surg. 1991;110(3):132-8
2059535
Magn Reson Imaging Clin N Am. 2000 May;8(2):243-70
10819914
Knee. 2006 Mar;13(2):137-44
16448817
Am J Sports Med. 2007 Oct;35(10 ):1756-69
17761605
J Bone Joint Surg Am. 1950 Oct;32 A(4):721-38
14784482