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Original ArticleOpen Access

Accuracy of a New Stress Radiographic Device in Diagnosing Anterior Cruciate Ligament Tear

Srisuwanporn P , Wachiratarapadorn S , Panyasakulwong R , Thuntong B , Cheecharern S , Precha W

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Srisuwanporn P, Wachiratarapadorn S, Panyasakulwong R, Thuntong B, Cheecharern S, Precha W. Accuracy of a New Stress Radiographic Device in Diagnosing Anterior Cruciate Ligament Tear. J Med Assoc Thai 2016;99:394.

Background: Anterior cruciate ligament (ACL) tears are clinically diagnosed by detection of anterior tibial translation on physical examination; however, this manual method of assessment is imprecise, subjective, and not reproducible. Recently a new instrument, a stress radiographic device (SRD), was produced to objectively measure these displacements.

Objective: To assess a new instrument, a SRD, in the measurement of anterior tibial translation in ACL-deficient knee compared to the healthy ACL knee.

Material and Method: The SRD was applied to 24 ACL-tear knees that were diagnosed by MRI as having complete ACL tears, and 24 healthy ACLs from the contralateral knee of each patient. Each knee was tested under a force 120 Newtons in a posterior to anterior direction to create anterior tibial translation at 20 degrees knee flexion. Side-to-side difference of anterior tibial translation (mm) was measured from radiographs.

Results: We studied 24 patients who had one knee with complete rupture of ACL diagnosed by MRI and the other with healthy ACL confirmed by clinical diagnosis. The mean anterior tibial translation before and after using the device was significantly lower in the healthy ACL group than in the ruptured ACL group. A stress radiographic device was used with a 4 mm side-to-side cut off point of difference of anterior tibial translation between pre- and post-stress displacement for diagnosis of complete rupture of anterior cruciate ligament. The sensitivity was 79% and specificity was 100%.

Conclusion: The new stress radiographic device is reliable and reproducible in diagnosis of complete rupture of anterior cruciate ligament.

Keywords: Anterior cruciate ligament tears, Anterior tibial translation, Stress radiographic device

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