Comparison between MRI and Direct Vision in Diagnosing Intraarticular Pathologies in Patients with anterior cruciate ligament Tearing: A Retrospective Study

The anterior cruciate ligament (ACL) is an important structure for maintaining the normal biomechanics of the knee and is the most commonly injured knee ligament. MRI has proved sensitivity and specificity in detecting intraarticular knee pathologies. The aim of this study was to compare the result of direct vision and MRI in detecting intraarticular pathologies in patient with ACL tearing. Subjects and Seventy patients with clinical examination and MRI of ACL tearing entered in the study. The age range was between 22 and 45 years (57 men and 13 women). The patients were scheduled for ACL reconstruction via mini- arthrotomy approach. After miniarthrotomy, the knee was examined directly for intraarticular pathology and if ACL was torn, ACL reconstruction was performed. The result of direct vision was recorded and compare with MRI of the patients after surgery. Sensitivity, specificity, positive and negative predictive values and kappa agreement measures were calculated. MRI had 98.5% sensitivity for ACL injuries. While for medial meniscus injuries, 73% sensitivity, and 93% specificity, for lateral meniscus 87.5% sensitivity and 95% specificit and for osteochondral lesions 40% sensitivity and 96% specificity. Injuries to menisci and cruciate ligaments can be diagnosed on MRI with a high degree of sensitivity and specificity. We recommend MRI as the primary diagnostic tool for internal knee derangements; however, in cases of ACL reconstruction it is advisable to use direct vision viewing of the knee before beginning the reconstruction.