Diagnosis of internal derangements of the knee. The role of arthroscopy

Ke, Dehaven; Hr, Collins

doi:10.2106/00004623-197557060-00014

Cited by 122 publications

(32 citation statements)

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“…The clinical diagnosis of meniscal and anterior cruciate injuries has been the subject of many reports [1,3,4,5,11,12,13,18,23,28,30]. Although arthrography and arthroscopy have made it possible to initiate prompt treatment, there are still difficulties in detecting tears of the lateral meniscus [1,4,5] and the posterior horn of the medial meniscus [9,15].…”

Section: Introductionmentioning

confidence: 99%

“…Although arthrography and arthroscopy have made it possible to initiate prompt treatment, there are still difficulties in detecting tears of the lateral meniscus [1,4,5] and the posterior horn of the medial meniscus [9,15].…”

Section: Introductionmentioning

confidence: 99%

“…Reports are rare concerning multiple lesions in the same knee. DeHaven and Collins made the correct clinical diagnosis in a prospective series in 72% [5].…”

Section: Introductionmentioning

confidence: 99%

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

Yoon

Rah

Park

1997

International Orthopaedics

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Summary. The diagnostic accuracy of clinical examination for internal derangement of the knee were evaluated by arthroscopy in 195 patients (200 knees). Radiographs were available and 50 patients had magnetic resonance imaging. The clinical diagnosis was correct in 104 knees (52%), incomplete in 70 (35%) and incorrect in 26 (13%). When there was a single abnormality the diagnosis was correct in 70%, but when more than 3 lesions were discovered the figure was 28%. All individual lesions were diagnosed correctly in more than 90%. The lesions most difficult to diagnose were chondral fractures, partial tears of the anterior cruciate ligament and loose bodies. Knees with acute lesions and those with a single diagnosis were significantly easier to diagnose (p 50.01). Age, sex, MRI and the surgeon were not significant.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Yoon

Rah

Park

1997

International Orthopaedics

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“…In early OA, radiographic observations have been correlated to arthroscopic findings (DeHaven and Collins 1975, Lysholm et al 1987, Brandt et al 1991, emphasizing the insensitivity of the radiographs for detecting early articular cartilage loss, but no such comparison between radiography and morphological changes has been described for more advance disease. The Ahlbäck classification has recently been reported to have poor reliability (Galli et al 2003).…”

mentioning

confidence: 99%

Ahlbäck grading of osteoarthritis of the knee: Poor reproducibility and validity based on visual inspection of the joint

Weidow

Cederlund

Ranstam³

et al. 2006

Acta Orthopaedica

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Background Staging of osteoarthritis (OA) of the knee is commonly based on the Ahlbäck classification. Its value has been questioned, however. We therefore evaluated the reproducibility and validity of this classification of knee osteoarthritis.Patients and methods 48 patients (48 knees) (medial OA: n = 30; lateral OA: n = 8) operated with total knee prostheses were studied. Weight-bearing radiographs were evaluated twice by 4 observers. Presence of bone attrition on radiographs was compared with observations of the resected parts of the distal femur and proximal tibia.Results When the same observer classified the radiographs twice according to Ahlbäck, the repeatability was fair in both medial OA (kappa values = 0.15-0.65) and lateral OA (0.59-0.76), and between different observers it was poor (kappa: 0.1).Comparison between radiographic classification and classification based on visual inspection of the bone pieces removed during arthroplasty revealed an acceptable sensitivity in both medial (67-95%) and lateral OA (43-86%), but the specificity was low (medial: 11-67%; lateral: 25-75%).Interpretation The main problem with the Ahlbäck classification was that a joint space could often be seen radiographically despite the presence of bone attrition on the preparations. According to our study, conventional radiographs do not give sufficient information for correct grading.

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“…It enables morphological evaluation of the surface, thickness, volume and subchondral bone (Figure 1). Arthroscopy -This is the gold standard examination for intra-articular pathological conditions of the knee (19) . Through using this tool, lesions can be classified, located and palpated ( Figure 2).…”

Section: Very Severe Lesionmentioning

confidence: 99%