Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACK GROUND:
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.
AIM OF THE STUDY:
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.
METHODS:
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.
RESULTS:
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.
CONCLUSION:
Most of ACL tears can be diagnosed by thorough history& repeated clinical examination only, considering arthroscopy as a last but a definite choice.