A prospective study of the accuracy of clinical examination evaluated by arthroscopy of the knee

Yoon, Young Sup; Rah, Jung-Ho; Park, H.-J.

doi:10.1007/s002640050155

Cited by 24 publications

(17 citation statements)

References 23 publications

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“…MRI's low sensitivity for chondral lesions has been reported before [17]. Our study form included no formal classification of chondral lesions, so we do not know the true nature of the chondral lesions we have missed.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

Halinen

Koivikko

Lindahl

et al. 2008

International Orthopaedics (SICOT)

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This study compares MRI with examination under anaesthesia to surgical findings in evaluating soft tissue injuries in acute multi-ligament knee trauma. Preoperative MRI was done for 44 patients who underwent surgery for grade III ACL and grade III medial collateral ligament (MCL) injury. In 21 cases both ACL and MCL were treated surgically, but in 23 only ACL. Intra-operative and MRI findings were compared. Accuracy of MRI for medial meniscal tears was 88.6%, sensitivity 80%, and specificity 91.2%; accuracy for lateral meniscal tears was 72.7%, sensitivity 55% and specificity 87.5%. Accuracy and sensitivity for severity of ACL tear was 93.2% and of MCL tear 86.4%. In 88.6% of the knees, bone bruises were visible, with anterolateral femoral and posterolateral tibial bone bruise being the most common. MRI revealed no chondral lesion, but arthroscopy revealed 11. In combined ACL-MCL ruptures, the incidence of concomitant injuries is high and the injuries are best detected with MRI.

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Section: Discussionmentioning

confidence: 99%

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

Halinen

Koivikko

Lindahl

et al. 2008

International Orthopaedics (SICOT)

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“…However, the value of MRI in the acutely injured knee is much debated. Some studies have found that MRI tends to overestimate the number of lesions, while others maintain that clinical examination of the knee alone is too inaccurate to detect all pathological conditions after an injury (Speer, Spritzer, Goldner, Garrett, 1991; Boden et al., 1992; Le Vot & Solacroup 1993; Kinnunen et al., 1994; Helmuth et al., 1996; Mackenzie, Dixon, Keene, Hollingworth, Lomas, Villar, 1996; Rangger et al., 1996; Twaddle et al., 1996; Williams et al., 1996; Yoon et al., 1997). Also it remains to be proven whether MRI findings have any influence on the prognosis for the patient and whether these findings should be reasonable for an alteration in treatment.…”

mentioning

confidence: 99%

Clinical decision making in the acutely injured knee based on repeat clinical examination and MRI

Odgaard

Tuxøe

Joergensen

et al. 2002

Scandinavian Med Sci Sports

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To determine the correlation between Magnetic Resonance Imaging (MRI) and clinical examination of the knee after an acute injury, and to see to what extent MRI affected the planned treatment, we examined 90 consecutive patients in a prospective study, clinically and with an extremity Magnetic Resonance (MR) scanner. The number of meniscal lesions, bone bruises and osteochondral lesions found on MRI was significantly higher than the clinical examinations indicated. Despite this, the treatment was only changed in 6 cases. In no case did MRI prevent a planned arthroscopy. MRI may reveal many clinically silent changes in the knee, also after minor injuries. The significance of these MRI findings must await long-term follow-up.

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“…Yoon et al [48] reported that the correct diagnosis of knee injuries was made in only 52 % of knees, incomplete diagnosis in 35 % of knees, and incorrect diagnosis in 13 % of knees. Oberlander et al [32] reported similar findings with correct diagnosis being made in 56 % of cases, incomplete diagnosis in 31 %, and incorrect diagnosis in 13 %.…”

Section: Discussionmentioning

confidence: 99%

Assessment of knee laxity using a robotic testing device: a comparison to the manual clinical knee examination

Branch

Stinton

Siebold³

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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PurposeThe purpose of this study was to collect knee laxity data using a robotic testing device. The data collected were then compared to the results obtained from manual clinical examination.MethodsTwo human cadavers were studied. A medial collateral ligament (MCL) tear was simulated in the left knee of cadaver 1, and a posterolateral corner (PLC) injury was simulated in the right knee of cadaver 2. Contralateral knees were left intact. Five blinded examiners carried out manual clinical examination on the knees. Laxity grades and a diagnosis were recorded. Using a robotic knee device which can measure knee laxity in three planes of motion: anterior–posterior, internal–external tibia rotation, and varus–valgus, quantitative data were obtained to document tibial motion relative to the femur.ResultsOne of the five examiners correctly diagnosed the MCL injury. Robotic testing showed a 1.7° larger valgus angle, 3° greater tibial internal rotation, and lower endpoint stiffness (11.1 vs. 24.6 Nm/°) in the MCL-injured knee during varus–valgus testing when compared to the intact knee and 4.9 mm greater medial tibial translation during rotational testing. Two of the five examiners correctly diagnosed the PLC injury, while the other examiners diagnosed an MCL tear. The PLC-injured knee demonstrated 4.1 mm more lateral tibial translation and 2.2 mm more posterior tibial translation during varus–valgus testing when compared to the intact knee.ConclusionsThe robotic testing device was able to provide objective numerical data that reflected differences between the injured knees and the uninjured knees in both cadavers. The examiners that performed the manual clinical examination on the cadaver knees proved to be poor at diagnosing the injuries. Robotic testing could act as an adjunct to the manual clinical examination by supplying numbers that could improve diagnosis of knee injury.Level of evidenceLevel II.

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A prospective study of the accuracy of clinical examination evaluated by arthroscopy of the knee

Cited by 24 publications

References 23 publications

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

Clinical decision making in the acutely injured knee based on repeat clinical examination and MRI

Assessment of knee laxity using a robotic testing device: a comparison to the manual clinical knee examination

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