caa a22 4500 605459347 CHVBK 20210128100233.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00167-014-2994-5 doi (NATIONALLICENCE)springer-10.1007/s00167-014-2994-5 Varus knee osteoarthritis: how can we identify ACL insufficiency? [Elektronische Daten] [Wenzel Waldstein, Christian Merle, Jad Monsef, Friedrich Boettner] Purpose: The aim of this prospective study was to determine the clinical value of lateral radiographs and corresponding MRI scans in the preoperative evaluation of the functional integrity of the anterior cruciate ligament (ACL) in a consecutive series of 78 patients (93 knees) with medial compartment osteoarthritis. Methods: All knees received standardised radiographs and MRI imagery. The wear pattern on the lateral radiograph was described based on a modified Keyes classification. On MRI, the ACL and the percentage of intact posterior cartilage in relation to the anteroposterior tibia width were assessed. Results: The MRI showed an intact ACL in 23 (25%) knees, evidence of ACL degeneration in 54 (58%) knees and a complete ACL tear in 16 (17%) knees. All knees with an intact ACL showed ≥14% intact posterior cartilage on sagittal MRI scans, except for one knee. All knees with a torn ACL demonstrated <14% intact posterior cartilage. Of the 54 knees with evidence of ACL degeneration, eight knees had <14% intact posterior cartilage similar to the wear pattern present in knees with torn ACLs. Out of the 24 knees with a torn or degenerated ACL and <14% intact posterior cartilage on MRI, 23 (96%) knees demonstrated posterior bony erosion on corresponding lateral radiographs. Conclusions: The assessment of intact posterior tibial cartilage on MRI and lateral radiographs helps to identify knees with functional ACL insufficiency. MRI with assessment of both the ACL morphology and the underlying tibial wear pattern appears to provide additional clinical benefit in cases in which the extent of posterior bony erosion on the lateral radiograph cannot be assessed with confidence. Level of evidence: Diagnostic study, Level II. Springer-Verlag Berlin Heidelberg, 2014 ACL nationallicence Function nationallicence Insufficiency nationallicence Degeneration nationallicence Cartilage wear pattern nationallicence MRI nationallicence Lateral radiographs nationallicence Waldstein Wenzel Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut Merle Christian Department of Orthopaedic and Trauma Surgery, University Hospital Heidelberg, Schlierbacher Landstrasse 200 A, 69118, Heidelberg, Germany aut Monsef Jad Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut Boettner Friedrich Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/8(2015-08-01), 2178-2184 0942-2056 23:8<2178 2015 23 167 https://doi.org/10.1007/s00167-014-2994-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-2994-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Waldstein Wenzel Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 700 1- Merle Christian Department of Orthopaedic and Trauma Surgery, University Hospital Heidelberg, Schlierbacher Landstrasse 200 A, 69118, Heidelberg, Germany aut NATIONALLICENCE 700 1- Monsef Jad Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 700 1- Boettner Friedrich Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/8(2015-08-01), 2178-2184 0942-2056 23:8<2178 2015 23 167