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Subject Area

Orthopedics

Article Type

Original Study

Abstract

Objectives: To investigate the diagnostic accuracy of meniscal and ligamentous knee injuries by clinical evaluation concerning arthroscopic examination.

Background: Knee arthroscopy is a commonly performed method for the evaluation and management of internal derangements of the knee, and its diagnostic accuracy has been reported to be 95%, provided that an experienced and proficient operator performs the diagnostic arthroscopy.

Patients & Methods: We conducted a prospective observational cross-section of a total of 62 patients who underwent knee arthroscopy in Menoufia University Hospitals between November 2020 and September 2021 for knee symptoms pre-operatively attributed to different knee pathologic conditions on arthroscopic examination.

Results: females represented 27.4% of them with ages ranging from 19 to 60 years with a mean age of 33.79 years, 64.5% had right side lesions, ACL injury, and meniscal injury evaluated by MRI and clinical examination to have a good expectation for surgery. Positive ADT, Lachmann, and Pivot shift tests or two of them can diagnose ACL tears with a sensitivity of 90.9%, specificity of 100%, a positive predictive value of 100%, a negative predictive value of 90.6%, and overall accuracy of 95.2%.

Conclusion: The pivot shift test yielded the best sensitivity, specificity and highest accuracy among clinical tests followed by the Lachmann test yet ADT had the lowest sensitivity and overall accuracy. MRI had overall accuracy and sensitivity similar to the Pivot shift test. The surgeon must correlate the clinical examination and the MRI to have a good decision making.

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