EVALUATION OF ACUTE ANTERIOR CRUCIATE LIG AMENT RUPTURES - THE ROLE OF ULTRASOUND IN ADDITION TO CLINICAL EXAMINATION

Post-traumatic knee injuries often deteriorate if reuptures of anterio r cruciate ligaments (ACL) are not treated adequately, Further diagnos tic procedures are required if pain-induced muscle contraction impairs clinical examination. The clinical relevance of sonography, however, for the diagnosis of ACL ruptures is controversial. Within 25 months, 74 patients were preoperatively evaluated clinically and by ultrasound , 58 ruptures of the ACL and 21 lesions of the collateral ligaments we re confirmed by arthroscopy or arthrotomy. In 16 cases a menisceal tea r was found, four patients had a luxation of the patella, and two had PCL ruptures. The sensitivity of the Lachman test was 93%, of the ante rior drawer test 68% and of the pivot shift test 48%. Ultrasound diagn osis revealed 88% of all ACL ruptures (91% if patients with bony ruptu res of the ACL were excluded), In 75% of ACL ruptures, a popping sensa tion was reported by the patients. In the case of uncertain diagnosis, examination with ultrasound could be easily performed before further operative diagnostic procedures are scheduled.