Keywords : Anterior cruciate ligament

Do All Anterior Cruciate Ligament Tears Need Reconstruction?

Qasim M.AL Janabi; Adnan H. Hnoosh; Ahmed N.M. Altaei

Iraqi Postgraduate Medical Journal, 2016, Volume 15, Issue 2, Pages 166-171

Anterior cruciate ligament (ACL) injury is common among active individuals, and mostly associated with other complex injuries in the knee. ACL reconstruction is vital for normal knee function. The treatment of ACL injuries of knee depend on many factors including Age of the patients, degree of laxity, level of activities and associated injuries .
To assess outcome after conservative management of ACL tear. Moreover, determine the patients who need reconstruction, and the best time to perform surgery.
Prospective study of 72 patients who had unilateral ACL tear, 61 males and 11females (age 18-40Y). 56 patients started management with rehabilitation program without reconstructive surgery, 12of them have underwent surgery after that because of unsatisfied outcome. ACLR performed for 28 patients 7 of them were female, complete ACL tear was observed in 21patients. Hamstring graft by one-incision technique were used: same protocol of rehabilitation was followed postoperatively. This study has been achieved in Al Shaheed Ghazi Al Hariri Hospital.
Average follow up period of 18 months, 78.5% of patient with rehabilitation (no ACLR) had good functional result. While all patients with ACLR have been satisfied where 85% of them return to their activity at level of I and II sport and 97% of quadriceps girth gaining compared to the sound side also observed at the end of follow up period.
Not all ACL tear need surgical reconstruction. It is indicated for high-risk life style and repeated attacks of giving way. There is no differences between early and late reconstruction.
KEYWORD: Anterior cruciate ligament, tear, ACLR.

Evaluation of the Clinical Examinations in Diagnosis of Anterior Cruciate Ligament(ACL)Tear in Comparison With A Definite Arthroscopic Diagnosis

Qasim Mohammed Shakir

Iraqi Postgraduate Medical Journal, 2007, Volume 6, Issue 3, Pages 194-197

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 & physical examination, then confirmed by direct arthroscopy.
We found that only 52 patients have got ACL tear, 49 of them (94%) were males & 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, & the main sign detected was knee joint effusion due to haemarthrosis.
The accuracies of Lachman test, Anterior Drawer Test & Pivot Shift T. were 94%, 82% & 58%
respectively, all were improved under G.A., particularly the PST.
Most of ACL tears can be diagnosed by thorough history& repeated clinical examination only, considering arthroscopy as a last but a definite choice.