Stoianov Anca Gabriela, Patrascu Jenel Marian, Hogea Bogdan Gheorghe, Andor Bogdan, Florescu Sorin, Misca Liviu Coriolan, Laza Ruxandra, Fericean Roxana Manuela, Mavrea Adelina, Terzi Artiom, Patrascu Jenel Marian
Department of Orthopedics and Traumatology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Diagnostics (Basel). 2023 Jul 12;13(14):2352. doi: 10.3390/diagnostics13142352.
Posterior cruciate ligament (PCL) injuries, though less common than other knee ligament injuries, pose significant management challenges. This study aimed to systematically review and analyze the current evidence on the use of point-of-care ultrasound (POCUS) for the evaluation and management of PCL injuries. It was hypothesized that POCUS has comparable diagnostic accuracy to magnetic resonance imaging (MRI) and that the use of POCUS improves patient outcomes and reduces healthcare costs. A comprehensive systematic review of articles published up to April 2023 was conducted using PubMed, Web of Science, Cochrane, and Scopus databases and adhered to the PRISMA guidelines. Studies were selected based on relevance to the research question, with a focus on diagnostic accuracy, reliability, clinical utility, and cost-effectiveness of POCUS in PCL injuries. Seven studies, analyzing a total of 242 patients with PCL injuries, were included. The reported sensitivity and specificity of POCUS for diagnosing PCL injuries ranged from 83.3% to 100% and 86.7% to 100%, respectively, across the studies. In one study, POCUS demonstrated a positive predictive value (PPV) of 87.9% and a negative predictive value (NPV) of 82.4%. Additionally, three studies reported 100% accuracy in PCL injury detection using POCUS, suggesting a substantial potential for cost savings by eliminating the need for MRI. This systematic review supports the use of POCUS in the evaluation and management of PCL injuries, suggesting that POCUS is a reliable, cost-effective tool with high diagnostic accuracy comparable to that of MRI, offering the potential to improve patient outcomes and reduce healthcare costs. The data collated in this review can inform clinical practice and guide future research in the field.
后交叉韧带（PCL）损伤虽然比其他膝关节韧带损伤少见，但在治疗方面带来了重大挑战。本研究旨在系统回顾和分析目前关于床旁超声（POCUS）用于评估和治疗PCL损伤的证据。研究假设POCUS具有与磁共振成像（MRI）相当的诊断准确性，并且使用POCUS可改善患者预后并降低医疗成本。使用PubMed、科学网、Cochrane和Scopus数据库对截至2023年4月发表的文章进行了全面的系统回顾，并遵循PRISMA指南。根据与研究问题的相关性选择研究，重点关注POCUS在PCL损伤中的诊断准确性、可靠性、临床实用性和成本效益。纳入了7项研究，共分析了242例PCL损伤患者。在各项研究中，POCUS诊断PCL损伤的敏感性和特异性分别为83.3%至100%和86.7%至100%。在一项研究中，POCUS的阳性预测值（PPV）为87.9%，阴性预测值（NPV）为82.4%。此外，三项研究报告使用POCUS检测PCL损伤的准确率为100%，这表明通过无需进行MRI检查有大幅节省成本的潜力。这项系统回顾支持在评估和治疗PCL损伤中使用POCUS，表明POCUS是一种可靠、具有成本效益的工具，诊断准确性高，与MRI相当，有可能改善患者预后并降低医疗成本。本综述整理的数据可为临床实践提供参考，并指导该领域的未来研究。
