The Efficacy of MRI in Anterior Cruciate Ligamant Injury

Ligament injuries of the knee joint are very common among competitive athletes. Acrurate assessment ot the nature of these injuries is a prerequisite for appropriate therapy. The purpose of this study is to evaluate the significance of MRI findings in assesing the status of ACL tear and associated injuries. 31 cases of ACL injuries were examined and reconstructed arthroscopically from Jan. 1997 to Sep. 1997 at Kyung Hee University Hospital. 1n all cases, we reviewed preoperative physical and MRI findings and performed postoperative radiologic assessments. Results were as follows; 1. Lachman test and Pivot shift test were positive in all 31 cases but anterior drawer test was positive in 29 case,s. 2. In MRI findings, 24 cases were interpretated as complete ACL tear and / cases as inccomplete ACL tear. But these 7 cases were confirmed as complete tear in mthroscopic exanunation with careful probing of ACL fiher. 3. MRI showed associated meniscal injuries in 19 cases(61%)-14 cases(74%) at medial meniscus, 5 cases(26%) at lateral meniscus. All cases were confirmed arthroscopically. In conc1usion, physical findings are more reliable than MRI findings in diagnosing the complete ACL tear and deciding the ACL reconstruction. But MRI findings are very helpful to assess the associated injuries and plan the treatments.

Arthroscopic Excision of the Complete Type of Suprapatellar Plica

The suprapatellar plica is a remnant of the embryonic septum separating the suprapatellar pouch from the knee joint. Complete type of suprapatellar plica is rarely reported and its clinlical significance is controversial. The purpose of this study is to verify the complete type of suprapatellar plica as an important cause of anterior knee pain and to evaluate the clinical results after arthroscopic excisien of it. From September 1991 to April 1997, we studied prospectively 54 patients, 90 knees which were diagnosed as cornplete type of suprapatellar plica preoperatively. The mean age was 32 years (15-57 years) and sex distribution was 14 males and 40 females. For the preoperative diagnosis, we checked clinical symptom, past history, physical finding and plain X-ray routinely and performed bone scan, double contrast arthrogram and MRI, if necessary. All patients complained vague anterior knee pain at standing, sitting, stair climbing and exercise for long times. All 90 knees were examined arthroscopically. Among them, 80 knees had complete type of suprapatellar plica and remaining 10 knees had other findings. After all, positive predictive value of preoperative diagnosis for complete type of suprapatellar plica was 89%. Among 36 patients diagnosed as bilateral preoperatively, 33 patients(92%) were confirmed as bilateral in arthroscopic examination. After arthroscopic excision of plica, clinical results were total relief of pain in 19 knees(24%), improvement in 55 knees(69%), no change in 6 knees(7%) and none of worsening. In conclusion, complete type of suprapatellar plica should be considered as an important cause of anterior knee pain especially which is vague, intermittent and bilateral.