Stress radiography in the diagnosis of anterior cruciate ligament deficiency

Garcés, Gerardo L.; Perdomo, Eva Bernete; Guerra, A; Cabrera-Bonilla, R.

doi:10.1007/bf00179966

Cited by 28 publications

(21 citation statements)

References 14 publications

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“…Normal SSD is near zero [20]. Different diagnostic thresholds have been reported in the literature ranging from SSD of 2 to 5 mm [14,17,21]. In patients with complete ACL tear, Panisset et al found average SSD to be 7.4 ± 4.3 mm and used SSD >5 mm as their diagnostic threshold using Telos stress imaging (Sn 80.9 %, sp 81.8 %) [5].…”

Section: Methods Of Quantificationmentioning

confidence: 99%

“…Another simple technique involves placing a sandbag onto the patient's leg in an appropriate position, typically weighing anywhere from 3 to 9 kg [9,11,15]. The Telos apparatus is also commonly used [2,5,[16][17][18][19]. This is a device which holds the femur and tibia in a fixed position, and then applies a reproducible force to the posterior tibia, producing anterior tibial translation.…”

Section: Force Applicationmentioning

confidence: 99%

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Anterior cruciate ligament assessment using arthrometry and stress imaging

Rohman

Macalena

2016

Curr Rev Musculoskelet Med

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Arthrometry and stress imaging are useful clinical tools for the objective assessment of anterior cruciate ligament (ACL) integrity. They are most frequently used for the diagnosis of a complete ACL tear when other workup is equivocal, in conjunction with history and clinical exam findings. Other applications include the diagnosis of partial ACL tears, injury prognosis, and post-operative monitoring. However, further studies are needed to validate these uses. Many different devices and techniques exist for objective examination, which have been compared in recent literature. Reliability and validity measures of these methods vary, and often depend upon examiner familiarity and skill. The KT series of devices is the current gold standard for arthrometry, although the newer robotic GNRB device shows promising early results. Newer methods of data interpretation have been developed for stress imaging, and portable technology may impact this field further.

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Section: Methods Of Quantificationmentioning

confidence: 99%

Section: Force Applicationmentioning

confidence: 99%

Anterior cruciate ligament assessment using arthrometry and stress imaging

Rohman

Macalena

2016

Curr Rev Musculoskelet Med

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“…The anterior translation of the tibia was measured on the radiograph (mm) and compared with the contralateral side. The difference between the injured and uninjured knee was greater than 5 mm in ACL deficient knees [11].…”

Section: Methodsmentioning

confidence: 79%

Functional Outcomes for Combined Acute Anterior and Posterior Cruciate Knee Injuries Treated Non-Operatively

Wada

Kimura²,

Tazawa³

et al. 2014

OJO

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Introduction: results after non-operative management for knees sustaining combined acute anterior and posterior cruciate ligament tears were presented. Subjects: 13 patients, 10 with medial, and 3 with lateral ligament injury. Methods: non-operative management consisted of employing a brace to prevent sagittal translation of the tibia. Quadriceps muscle and early passive knee motion exercises in the brace was encouraged immediately after arthroscopy. Weight-bearing was forbidden for 3 weeks. The brace was not removed for 3 months. Follow-up periods ranged from 2 to 6 years (mean, 3 years 2 months). Results: none, but one patient had a slight restriction of knee flexion. Quadriceps muscle strength revealed an average of 89.0% of normal side. The knee score indicated 2 patients rated good, 3 rated fair, and 8 rated poor. The score correlated with measurements of anterior and posterior translation on the stress radiograph significantly. Stress radiography revealed that anterior laxity was reduced better than posterior laxity significantly. Conclusion: non-operative brace therapy can be considered for this combined injury as the initial treatment. A late reconstruction would be performed when the result was not satisfactory. Preserved range of motion and muscle strength after brace therapy had a great advantage to the late reconstructive surgery.

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“…Beldame et al [9] have reported a specificity of 59% with 4 mm of anterior tibial translation as a cutoff value when 250 N is loaded using Telos device. These values of sensitivities seem to be low considering that physical examination by an expert has sensitivity of 85% with Lachman test according to a meta-analysis conducted by Benjaminse et al [23] or the study of Garces et al [24]. However, these studies did not specify the time interval between injury and the radiologic evaluation.…”

Section: Discussionmentioning

confidence: 99%

Anterior tibial displacement on preoperative stress radiography of ACL-injured knee depending on knee flexion angle

Noh

Nam

Roh

2019

Knee Surg & Relat Res

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Purpose: To compare side-to-side difference (SSD) of anterior tibial translation in instrumented stress radiography for each series of anterior cruciate ligament (ACL)-injured subjects according to knee flexion angle. Methods: Forty subjects who were suspected of having significant ACL injury by manual Lachman test and MRI were recruited for this prospective study. These subjects took stress radiographs for both knees with corresponding knee flexion of 10°(series M1) and 30°(series M2) using Telos stress device. Mean SSDs of M1 and M2 were compared. Sensitivities of M1 and M2 were assessed using the SSD ≥ 3 mm or ≥ 5 mm as a cutoff value. Results: Mean SSDs in series M1 and M2 were 4.22 ± 3.72 mm and 3.25 ± 3.30 mm, respectively (p < 0.001). When 3 mm of SSD was used as a cutoff value, sensitivities of series M1 and M2 were 47.5% (19/40) and 32.5% (13/40), respectively (p = 0.171). When 5 mm of SSD was used as a cutoff value, sensitivities of series M1 and M2 were 45.0% (18/40) and 22.5% (9/40), respectively (p = 0.033). Conclusions: Anterior tibial translation on stress radiographs using a Telos device is more prominent when knee flexion angle is 10°compared to that when knee flexion angle is 30°. However, stress radiography using Telos device, either at 10°or 30°of knee flexion, might not be suitable to make decision on surgical treatment due to relatively low sensitivities.

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Stress radiography in the diagnosis of anterior cruciate ligament deficiency

Cited by 28 publications

References 14 publications

Anterior cruciate ligament assessment using arthrometry and stress imaging

Anterior cruciate ligament assessment using arthrometry and stress imaging

Functional Outcomes for Combined Acute Anterior and Posterior Cruciate Knee Injuries Treated Non-Operatively

Anterior tibial displacement on preoperative stress radiography of ACL-injured knee depending on knee flexion angle

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