The accuracy of magnetic resonance imaging in diagnosing chronic posterior cruciate ligament injury

Servant, Chris; Ramos, James; Thomas, Neil P.

doi:10.1016/j.knee.2003.11.005

Cited by 56 publications

(28 citation statements)

References 17 publications

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“…Recent studies have demonstrated that the PCL can assume a normal appearance on MRI as early as 6 months after injury. 77,78 This MRI change does not correlate with improvement in clinical examination. In the case of chronic PCL injuries, baseline and serial bone scans are used to monitor changes that may indicate the development of arthrosis mostly in the medial and patellofemoral compartments.…”

Section: Imaging Studiesmentioning

confidence: 84%

Current Concepts Review: The Posterior Cruciate Ligament

2010

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Injuries to the posterior cruciate ligament (PCL) and methods of treatment of the injured PCL have historically been surrounded by controversy in the orthopedic community. The infrequent occurrence of PCL injuries and PCL-based, multiple ligament knee injuries has led to limitations in clinical studies and a subsequent lag in basic science and clinical research compared with that for other ligamentous injuries. In recent years, new studies have elucidated the biomechanical function and complex anatomy of the PCL leading to an increased interest in research, understanding, and treatment of these complex injuries. In addition to improved understanding of knee ligament structure and biomechanics, technical advancements in allograft tissue, surgical instrumentation, and graft tensioning and fixation methods and improved surgical techniques and postoperative rehabilitation methods have enhanced the results in PCL reconstruction and PCL-based, multiple ligament knee surgical outcomes.

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Section: Imaging Studiesmentioning

confidence: 84%

Current Concepts Review: The Posterior Cruciate Ligament

2010

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“…MRI have proven to be a very accurate technique for diagnosing PCL tears, especially for acute tears [27], with sensitivity values of 100 % and specificity values of 97 to 100 % [28–32]. With thorough MRI information of the PCL attachment, it would provide some reference data to assist orthopaedic surgeons with intraoperative and postoperative assessments of correct tunnel placement during arthroscopic anatomic PCL reconstruction.…”

Section: Discussionmentioning

confidence: 99%

MRI analysis of tibial PCL attachment in a large population of adult patients: reference data for anatomic PCL reconstruction

Teng

Guo

Meng

et al. 2016

BMC Musculoskelet Disord

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BackgroundConsistent reference data used for anatomic posterior cruciate ligament (PCL) reconstruction is not well defined. Quantitative guidelines defining the location of PCL attachment would aid in performing anatomic PCL reconstruction. The purpose was to characterize anatomic parameters of the PCL tibial attachment based on magnetic resonance imaging (MRI) in a large population of adult knees.MethodsThe PCL tibial attachment site was examined in 736 adult knees with an intact PCL using 3.0-T proton density–weighted sagittal MRI. The outcomes measured were the anterior-posterior diameter (APD) of the tibial plateau; angle between the tibial plateau and the posterior tibial ‘shelf’ (the slope where the PCL tibial attachment site was) (PTS); length of the PTS; proximal, central, and distal PCL attachment positions as well as the width of the PCL attachment site; and vertical dimension of the PCL attachment site inferior from the tibial plateau.ResultsThe average APD of the tibia plateau was 33.6 ± 3.5 mm, yielding significant differences between males (35.5 ± 3.0 mm) and females (31.6 ± 2.7 mm), P <.05, and there was a significantly decreasing trend with increasing age in males (P <.05). Mean angle between the tibial plateau and the PTS was 122.4° ± 8.1°, and subgroup analysis showed that the young group had a differently smaller angle (120.9° ± 7.5°) than the middle-aged (123.7° ± 8.2°) and the old (123.4° ± 7.7°) in males population, while there were no significant differences between sexes (P >.05). The proximal, central positions and width of the PCL attachment site were 13.4 ± 3.0 mm, 17.8 ± 3.0 mm and 9.6 ± 2.4 mm along the PTS, with significant differences between males and females (P <.05), and accounted for 60.0 % ± 9.1 %, 80.0 % ± 4.6 % and 43.3 % ± 9.7 % of the PTS respectively, with no significant differences between sexes and among age groups (all P >.05).ConclusionsThis study provides reference data of the tibial PCL attachment based on MRI in the sagittal orientation. In analysis of retrospective data from a large population of adult patients, the quantitative values can be used as references to define the inserted angle and depth of the drill guide, and the exact position and size of the tibial PCL tunnel for performing arthroscopic anatomic PCL reconstruction.

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“…Reports have shown that it can have a sensitivity of up to 100% in the diagnosis of acute PCL tears, 31,32 however, has been found to be less accurate in the diagnosis of chronic PCL tears. 33 Another advantage to MRI as the imaging modality of choice is that it offers information on the menisci, articular cartilage, and other ligaments within the knee, all of which can impact the treatment plan ( Figure 6). …”

Section: Imagingmentioning

confidence: 99%