The Journal of Bone and Joint Surgery, Vol 65, Issue 2 175-183, Copyright © 1983 by Journal of Bone and Joint Surgery, Inc
The accuracy of double-contrast arthrographic evaluation of the anterior cruciate ligament. A retrospective review of one hundred and sixty-three knees with surgical confirmation
H Pavlov, RF Warren, MF Sherman and PD Cayea
In a retrospective review of 163 knees, the double-contrast arthrogram
proved to be an accurate method of evaluating the anterior cruciate
ligament. The status of the ligament was examined arthrographically with
two stress lateral projections: a horizontal cross-table radiograph and a
fluoroscopic spot radiograph. The condition of the ligament was interpreted
as being normal, lax but intact, torn with intact synovial tissue, or torn
or absent. The status of the ligament was subsequently determined at either
arthrotomy or arthroscopy by inspection, palpation, and judgment of the
degree of tension under stress. The arthrographic diagnosis was found to be
91.4 per cent accurate within the individual subclassifications and 95 per
cent accurate in confirming the ligament to be either intact or abnormal.
Injury to the anterior cruciate ligament frequently occurs in association
with meniscal tears. In our series, 138 of the 163 knees had either a
meniscal or a cruciate lesion, or both. Of these, forty-one (30 per cent)
had a meniscal lesion, thirty-four (25 per cent) had a cruciate lesion, and
sixty-three (45 per cent) had both. We have found the double-contrast
arthrogram to be an accurate method of determining the condition of both
the anterior cruciate ligament and the menisci in a single outpatient
examination.
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