Arthroscopic, Magnetic Resonance Imaging and clinical evaluation of meniscal tears in patients with Chronic Anterior Cruciate Ligament Tears

Dr. Ankit Syal; Dr. Yash Bharat Shah; Dr. Chintan Vinod Desai; Dr. Suryaprakash Pitamber Chandani

Volume : III, Issue : VII, July - 2014

Arthroscopic, Magnetic Resonance Imaging and clinical evaluation of meniscal tears in patients with Chronic Anterior Cruciate Ligament Tears

Dr. Ankit Syal, Dr. Yash Bharat Shah, Dr. Chintan Vinod Desai, Dr. Suryaprakash Pitamber Chandani

Abstract :

Purpose: Ours is a prospective cross sectional study performed to evaluate the incidence of meniscus tears arthroscopically and the effectiveness of magnetic resonance imaging (MRI-1.5 Tesla) and clinical examination in detecting these lesions in patients with chronic anterior cruciate ligament (ACL) tears. Methods: We reviewed 99 patients (92 male and 7 female) with a mean age of 28.4 years (range, 15 to 52 years) who underwent ACL reconstruction for chronic ACL tears. Injuries were classified as chronic because arthroscopy was performed after more than 6 weeks of injury. All 99 patients had clinical and MRI evaluation followed by knee arthroscopy. The presence of meniscus tears was analyzed. The sensitivity, specificity, positive predictive value and negative predictive value of clinical examination and MRI was calculated and compared. Results: On arthroscopy, a medial meniscus tear was found in 39 patients (39.4%), a lateral meniscus tear is found in 23 patients (23.23%), both meniscus were torn in 16 patients (16.16%) and no meniscus lesions were found in 21 patients (21.21%). The sensitivity, specificity, positive predictive value and negative predictive value for detecting medial meniscus tears in Chronic ACL tears on clinical examination were 85.45%, 65.9%, 75.8% and 78.4% respectively; the sensitivity, specificity, positive predictive value and negative predictive value for detecting medial meniscus tears on MRI were 74.45%, 59.1%, 69.5% and 65%. Similarly the sensitivity, specificity, positive predictive value and negative predictive value for detecting lateral meniscus tears in Chronic ACL tears on clinical examination were 48.7%, 96.7%, 90.5% and 74.35%; the sensitivity, specificity, positive predictive value and negative predictive value for detecting lateral meniscus tears on MRI were 46.15%, 95%, 85.71% and 73%. Conclusion: We conclude from our study that in patients on chronic ACL tear patients, the prevalence of medial meniscus tears seems to be high