Cavinatto Leonardo, Gupta Sunny, Morgan Craig, Bartolozzi Arthur R
Jefferson 3B Orthopaedic Institute, Philadelphia, Pennsylvania.
Morgan-Kalman Clinic, Wilmington, Delaware.
J Knee Surg. 2019 Jul;32(7):620-623. doi: 10.1055/s-0038-1666827. Epub 2018 Jul 10.
Partial tears of the anterior cruciate ligament (ACL) recently regained attention due to a better understanding of the two distinct bundles of the ligament and the possibility of single-bundle reconstruction procedures. An accurate diagnosis is important as it influences treatment options and patient prognosis. The aim of this study was to evaluate the value of examination under anesthesia (EUA) and magnetic resonance imaging (MRI) for differentiating partial from complete ACL tears. For this purpose, this prospective case series included 95 consecutive patients undergoing primary ACL reconstruction surgeries. MRI, EUA, and MRI combined with EUA were performed preoperatively, and results were compared with arthroscopy. Our data showed that ACL lesions were diagnosed as partial tears in 42.1% ( = 40) of EUA, 23.2% ( = 22) of MRI, and 11.6% ( = 11) of arthroscopies. EUA and MRI demonstrated sensitivity of 100 and 90.1%, and specificity of 65.5 and 85.6%, respectively. Combined EUA and MRI demonstrated sensitivity of 100% and specificity of 83.1%. Our study revealed that preoperatively MRI and EUA may help surgeons early identify partial ACL tears and influence treatment decisions.
由于对前交叉韧带（ACL）两个不同束的更好理解以及单束重建手术的可能性，ACL部分撕裂最近重新受到关注。准确的诊断很重要，因为它会影响治疗选择和患者预后。本研究的目的是评估麻醉下检查（EUA）和磁共振成像（MRI）在区分ACL部分撕裂与完全撕裂方面的价值。为此，该前瞻性病例系列纳入了95例连续接受初次ACL重建手术的患者。术前进行了MRI、EUA以及MRI联合EUA检查，并将结果与关节镜检查结果进行比较。我们的数据显示，在EUA检查中，42.1%（n = 40）的ACL损伤被诊断为部分撕裂，MRI检查中为23.2%（n = 22），关节镜检查中为11.6%（n = 11）。EUA和MRI的敏感性分别为100%和90.1%，特异性分别为65.5%和85.6%。EUA与MRI联合检查的敏感性为100%，特异性为83.1%。我们的研究表明，术前MRI和EUA可能有助于外科医生早期识别ACL部分撕裂并影响治疗决策。
