Can MRI Distinguish between a Partial Anterior Cruciate Ligament (ACL) Tear and a Normal ACL?

Authors

  • Yoshinori Mikashima Department of Orthopedics and Oume Knee Surgery Center, Takagi Hospital, Tokyo, Japan and Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
  • Taisuke Tomatsu Department of Orthopedics and Oume Knee Surgery Center, Takagi Hospital, Tokyo, Japan
  • Motoko Miyawaki Department of Orthopedics and Oume Knee Surgery Center, Takagi Hospital, Tokyo, Japan and Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
  • Takeshi Koshiishi Department of Radiology, Takagi Hospital, Tokyo, Japan
  • Tadashi Takagi Department of Radiology, Takagi Hospital, Tokyo, Japan
  • Katsunori Ikari Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
  • Shigeki Momohara Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan

DOI:

https://doi.org/10.12974/2313-0954.2016.03.02.2

Keywords:

A partial anterior cruciate ligament tear, MRI, arthroscopy.

Abstract

Objective: The purpose of this study was to determine whether Magnetic resonance imaging (MRI) can distinguish between a partial anterior cruciate ligament (ACL) tear and a normal ACL.

Materials and Methods: MR images of 20 patients with an arthroscopically confirmed partial ACL tear were retrospectively interpreted by the author, comparing with normal ACLs.

Results and Discussion: All knees with a partial ACL tear had a continuous band of low signal, of which 15 had no increased signal intensity on proton density-weighted images. MRI could not distinguish between a partial ACL tear and a normal ACL. Orthopedic surgeons had better consider an ACL tear when a patient has traumatic hemarthrosis or anxiety provoked by the sensation of the knee ‘going out’ or ‘giving way’ during the pivot shift test, even if the ACL has a continuous band of low signal on the oblique sagittal view on MRI. 

References

Barrack RL, Buckley SL and Bruckner JD. Partial versus complete acute anterior cruciate ligament tears. The results of nonoperative treatment. J Bone Joint Surg Br 1990; 72: 622-624.

Boeree NR, Watkinson AF, Ackroyd CE and Johason C. Magnetic resonance imaging of meniscal and cruciate injuries of the knee. J Bone Joint Surg Br 1991; 73: 452-457.

Clayton RA and Court-Brown CM. The epidemiology of musculoskeletal tendinous and ligamentous injuries. Injury 2008; 39: 1338-1344. http://dx.doi.org/10.1016/j.injury.2008.06.021

Fischer SP, Fox JM, Del Pizzo W, Friedman MJ, et al. Accuracy of diagnoses from magnetic resonance imaging of the knee. J Bone Joint Surg Am 1991; 73: 2-10. http://dx.doi.org/10.2106/00004623-199173010-00002

Fritschy F, Panoussopoulos A, Wallensten R, et al. Can we predict the outcome of a partial rupture of the anterior cruciate ligament? A prospective study of 43 cases. Knee Surg Sports Traumatol Arthrosc 1997; 5: 2-5. http://dx.doi.org/10.1007/s001670050015

Lefevre N, Naouri J, F, Bohu Y, et al. Partial tears of the anterior cruciate ligament: diagnostic performance of isotropic three-dimensional fast spin echo MRI. Eur J Orthop Surg Traumatol 2014; 24: 85-91. http://dx.doi.org/10.1007/s00590-012-1135-4

Lehnert M, Eisenschenk A and Zellner A. Results of conservative treatment of partial tears of the anterior cruciate ligament. Int Orthop 1993; 17: 219-223. http://dx.doi.org/10.1007/BF00194182

Liu W, Maitland ME and Bell GD. A modeling study of partial ACL injury: simulated KT-2000 arthrometer tests. J Biomech Eng 2002; 124: 294-301. http://dx.doi.org/10.1115/1.1468636

Maclure M and Willette WC. Misinter pretation and misuse of the kappa statistic. Am J Epidemiol 1987; 126: 161-169. http://dx.doi.org/10.1093/aje/126.2.161

Nakajima H, Kondo M, Kurosawa H and Fukubayashi T. Insufficiency of the anterior cruciate ligament. Review of our 118 cases. Arch Orthop Trauma Surg 1979; 95-4: 233-240.

Noyes FR, Mooar LA, Moorman CT and McGinniss GH. Partial tears of the anterior cruciate ligament. Progression to complete ligament deficiency. J Bone Joint Surg Br 1989; 71: 825-833.

Noyes FR, Bassett RW, Grood ES and Butler DL. Arthroscopy in Acute Traumatic Hemarthrosis of the Knee. J Bone Joint Surg Am 1980; 62: 687-695. http://dx.doi.org/10.2106/00004623-198062050-00001

Odenstein M, Lysholm J and Gillquist J. The course of partial anterior cruciate ligament ruptures. Am J Sports Med 1985; 13: 183-186. http://dx.doi.org/10.1177/036354658501300307

Sandberg R and Balkfors B. Partial rupture of the anterior cruciate ligament. Clin Ortop 1987; 220: 176-178. http://dx.doi.org/10.1097/00003086-198707000-00023

Steckel H, Vadala G, Davis D and Fu FH. 2D and 3D 3-tesla magnetic resonance imaging of the double bundle structure in anterior cruciate ligament anatomy. Knee Surg Sports Traumatol Arthrosc 2006; 14: 1151-1158. http://dx.doi.org/10.1007/s00167-006-0185-8

Steckel H, Vadala G, Davis D, et al. 3-T MR imaging of partial ACL tears: a cadaver study. Knee Surg Sports Traumatol Arthrosc 2007; 15: 1066-1071. http://dx.doi.org/10.1007/s00167-007-0337-5

Tung GA, Davis LM, Wiggings ME and Fadale PD. Tears of the anterior cruciate ligament: Primary and secondary signs at MR imaging. Radiology 1993; 188: 661-667. http://dx.doi.org/10.1148/radiology.188.3.8351329

Umans H, Wimpfheimer O, Haramati N, et al. Diagnosis of partial tears of the anterior cruciate ligament of the knee: Value of MR imaging. Am J Roentgenol 1995; 165-4: 893-987.

Van Dyke P, De Smet E, Veruser J, et al. Partial tear of the anterior cruciate ligament of the knee: injury patterns on MR imaging. Knee Surg Sports Traumatol Arthrosc 2012; 20: 256-261. http://dx.doi.org/10.1007/s00167-011-1617-7

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Published

2016-09-04

How to Cite

Mikashima, Y., Tomatsu, T., Miyawaki, M., Koshiishi, T., Takagi, T., Ikari, K., & Momohara, S. (2016). Can MRI Distinguish between a Partial Anterior Cruciate Ligament (ACL) Tear and a Normal ACL?. International Journal of Orthopedics and Rehabilitation, 3(2), 51–57. https://doi.org/10.12974/2313-0954.2016.03.02.2

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