Evaluation of the clinical examinations in diagnosis of anterior cruciate ligament [ACL] tear in comparison with a definite arthroscopic diagnosis

ABSTRACT

The cruciate ligaments consists of a pair of very strong ligaments, connecting tibia to femur crossing like the limbs of letter X and that is why they are called crucial, mostly injured in noncontact sport actions leading to knee instability. To determine the accuracy of the clinical approach in the diagnosis of ACL tear. We used diagnostic arthroscopy as a reference standard for evaluating our results by applying it to all the patients. During the period from Dec-2000 to Oct-2002, we led a prospective study of 72 patients with suspected ACL tear, depending on careful history and physical examination, then confirmed by direct arthroscopy. We found that only 52 patients have got ACL tear, 49 of them [94%] were males and 3 [6%] were females. The age range was from 17-49 years, with a mean of 27.5 years, 42% of the patients had associated meniscal injuries. The commonest symptom was a heard pop, and the main sign detected was knee joint effusion due to haemarthrosis. The accuracies of Lachman test, Anterior Drawer Test and Pivot Shift T. were 94%, 82% and 58% respectively, all were improved under G.A., particularly the PST. Most of ACL tears can be diagnosed by thorough history and repeated clinical examination only, considering arthroscopy as a last but a definite choice