MRI Diagnosis and Grading of Anterior Cruciate Ligament Injuries

Ali Junaid  Dar; Akash  John; Shahraz  Ashraf; Tallat Anwar  Faridi; Sana  Zahid; Abu Bakar  Nazir

doi:10.54393/pbmj.v5i1.128

Authors

Ali Junaid Dar University Institute of Radiological and Medical Imaging Sciences, The University of Lahore, Gujrat Campus
Akash John University Institute of Radiological and Medical Imaging Sciences, The University of Lahore, Gujrat Campus
Shahraz Ashraf University Institute of Radiological and Medical Imaging Sciences, The University of Lahore, Gujrat Campus
Tallat Anwar Faridi University Institute of Public Health, University of Lahore, Lahore, Pakistan
Sana Zahid University Institute of Public Health, University of Lahore
Abu Bakar Nazir King Edward Medical University, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v5i1.128

Abstract

The ACL joins the thighbone's (femur) bottom to the shinbone's top (tibia). The ACL aids in the stability of the knee. If the anterior cruciate ligament is stretched too far, it might rip. The tear could be partial (through a section of the ACL) or full (through the entire ACL) (all the way through the ACL).Objective: To determine the grading and evaluation of ACL Injuries on Magnetic Resonance Imaging.Material and Methods: A Descriptive cross sectional study was conducted in 9 Months from January 2021 to September 2021. The data of 103 Patients was collected through convenient sampling in Radiology Department including Anterior Cruciate Ligament Injuries in all the population diagnosed on Magnetic Resonance Imaging (MRI). Physical complaints, Patient History and Demographic data were displayed on patient’s reports and used for data analysis. MRI scans was performed on 1.5 T- Scanner (Phillips) and data was collected, recorded and analyzed on SPSS as frequency tables and Pie Charts. Results:A total of 103 Patients were included following Grade 1, Grade 2 & Grade 3 Injuries. The data was collected and distributed into Three Age groups commonly 26-35 have 49 (47.6%) and the occurrence of ACL Injuries in specific gender as 74 females and 29 males. Grade 1 contains 49 (47.6%). The Grade 2 Injuries on ACL evaluated the frequency 35 (34%) Partial Tear which is due to a stretch but did not tear and making ligament loosen it. Grade 3 has the most Severe ACL Injuries with Complete Ligament Tear diagnosed on Magnetic Resonance Imaging and shows the frequency of 19 (18.4). Female Patients associated with Athletics and Sports activities were more common. Conclusion:In conclusion the ACL Injuries are common in Female because of Sports and Athletic Injuriesbecause of the smaller intercondylar notch. Women are three times more likely than males to sustain ACL injuries. MRI is the gold standard for diagnosing ACL injuries, and it has demonstrated to be quite accurate

References

Rayan F, Bhonsle S, Shukla DD. Clinical, MRI, and arthroscopic correlation in meniscal and anterior cruciate ligament injuries. International orthopaedics. 2009;33(1):129-32.

https://doi.org/10.1007/s00264-008-0520-4

Prince JS, Laor T, Bean JA. MRI of anterior cruciate ligament injuries and associated findings in the pediatric knee: changes with skeletal maturation. American Journal of Roentgenology. 2005;185(3):756-762.

https://doi.org/10.2214/ajr.185.3.01850756

Namiri NK, Flament I, Astuto B, Shah R, Tibrewala R, Caliva F, et al. Deep learning for hierarchical severity staging of anterior cruciate ligament injuries from MRI. Radiology: Artificial Intelligence. 2020;2(4):e190207.

https://doi.org/10.1148/ryai.2020190207

Ferretti A, Monaco E, Redler A, Argento G, De Carli A, Saithna A, et al. High prevalence of anterolateral ligament abnormalities on MRI in knees with acute anterior cruciate ligament injuries: a case-control series from the SANTI Study Group. Orthopaedic journal of sports medicine. 2019;7(6):2325967119852916.

https://doi.org/10.1177/2325967119852916

Choi WR, Yang J-H, Jeong S-Y, Lee JK. MRI comparison of injury mechanism and anatomical factors between sexes in non-contact anterior cruciate ligament injuries. PLoS one. 2019;14(8):e0219586.

https://doi.org/10.1371/journal.pone.0219586

Musahl V, Rahnemai-Azar AA, Costello J, Arner JW, Fu FH, Hoshino Y, et al. The influence of meniscal and anterolateral capsular injury on knee laxity in patients with anterior cruciate ligament injuries. The American journal of sports medicine. 2016;44(12):3126-3131.

https://doi.org/10.1177/0363546516659649

Boden BP, Sheehan FT, Torg JS, Hewett TE. Non-contact ACL injuries: mechanisms and risk factors. The Journal of the American Academy of Orthopaedic Surgeons. 2010;18(9):520.

https://doi.org/10.5435/00124635-201009000-00003

Stijak L, Bumbaširević M, Kadija M, Stanković G, Herzog R, Filipović B. Morphometric parameters as risk factors for anterior cruciate ligament injuries-A MRI case-control study. Vojnosanitetski pregled. 2014;71(3).

https://doi.org/10.2298/VSP1403271S

Jarbo KA, Hartigan DE, Scott KL, Patel KA, Chhabra A. Accuracy of the lever sign test in the diagnosis of anterior cruciate ligament injuries. Orthopaedic journal of sports medicine. 2017;5(10):2325967117729809.

https://doi.org/10.1177/2325967117729809

Klass D, Toms AP, Greenwood R, Hopgood P. MR imaging of acute anterior cruciate ligament injuries. The Knee. 2007;14(5):339-347.

https://doi.org/10.1016/j.knee.2007.04.008

Park JS, Nam DC, Kim DH, Kim HK, Hwang SC. Measurement of knee morphometrics using MRI: a comparative study between ACL-injured and non-injured knees. Knee surgery & related research. 2012;24(3):180.

https://doi.org/10.5792/ksrr.2012.24.3.180

Hoteya K, Kato Y, Motojima S, Ingham SJ, Horaguchi T, Saito A, et al. Association between intercondylar notch narrowing and bilateral anterior cruciate ligament injuries in athletes. Archives of orthopaedic and trauma surgery. 2011;131(3):371-376.

https://doi.org/10.1007/s00402-010-1254-5

Helito CP, Helito PVP, Assirati LFB, Longo CH, Bordalo-Rodrigues M, de Souza FF. Magnetic resonance imaging evaluation of the anterolateral ligament in acute anterior cruciate ligament injuries in an adolescent population. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2019;35(7):2136-2142.

https://doi.org/10.1016/j.arthro.2019.02.034

Nam T-S, Kim MK, Ahn JH. Efficacy of magnetic resonance imaging evaluation for meniscal tear in acute anterior cruciate ligament injuries. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2014;30(4):475-482.

https://doi.org/10.1016/j.arthro.2013.12.016

Popkin CA, Wright ML, Pennock AT, Vogel LA, Padaki A, Redler LH, et al. Trends in management and complications of anterior cruciate ligament injuries in pediatric patients: a survey of the PRiSM Society. J Pediatr Orthop. 2018;38(2):e61-e5.

https://doi.org/10.1097/BPO.0000000000001098

Wittstein J, Vinson E, Garrett W. Comparison between sexes of bone contusions and meniscal tear patterns in noncontact anterior cruciate ligament injuries. The American journal of sports medicine. 2014;42(6):1401-1407.

https://doi.org/10.1177/0363546514527415

Araujo P, van Eck CF, Torabi M, Fu FH. How to optimize the use of MRI in anatomic ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. 2013;21(7):1495-1501.

https://doi.org/10.1007/s00167-012-2153-9

Zhang Z-y, Wang C, Maimaitimin M, Huang H-j, Pan X-y, Maimaitijiang P, et al. Anterior and rotational tibial subluxation in the setting of anterior cruciate ligament injuries: An MRI analysis. The Knee. 2021;33:365-373.

https://doi.org/10.1016/j.knee.2021.10.012

Dekker TJ, Rush JK, Schmitz MR. What's new in pediatric and adolescent anterior cruciate ligament injuries? Journal of Pediatric Orthopaedics. 2018;38(3):185-192.

https://doi.org/10.1097/BPO.0000000000000792

Dufka FL, Lansdown DA, Zhang AL, Allen CR, Ma CB, Feeley BT. Accuracy of MRI evaluation of meniscus tears in the setting of ACL injuries. The Knee. 2016;23(3):460-464.

https://doi.org/10.1016/j.knee.2016.01.018

Chang MJ, Chang CB, Choi J-Y, Won HH, Kim TK. How useful is MRI in diagnosing isolated bundle ACL injuries? Clinical Orthopaedics and Related Research®. 2013;471(10):3283-3290.

https://doi.org/10.1007/s11999-013-3055-y

Kaeding CC, Pedroza AD, Reinke EK, Huston LJ, Hewett TE, Flanigan DC, et al. Change in anterior cruciate ligament graft choice and outcomes over time. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2017;33(11):2007-2014.

https://doi.org/10.1016/j.arthro.2017.06.019