European Journal of Molecular & Clinical Medicine

Since its introduction to musculoskeletal imaging in early 1980, MRI has revolutionized diagnostic imaging of the knee. It has, therefore, become the examination of choice in the evaluation of internal joint structures of the knee like menisci, cruciate ligaments and articular cartilage.
Purpose: The objectives of this study is to describe the most commonly injured ligament of knee, MRI features of various Ligament injuries and associations, and most common age group involved in ligament injuries of knee.
Materials and Methods: MR imaging studies of the knee were performed in 120 patients with history of painful knee joint and suspected ligament injury (men, women; mean age 33.86 years) using a 1.5 T MR machine. The sequences included coronal and sagittal PD, sagittal T2 FSE, fat suppressed T2 FSE, STIR axial and coronal. Knee MR studies were obtained to evaluate ligaments and menisci.
Results: Out of 120 casses ACL tears arePresent in 92 cases and absent in 28 cases. Among 92 cases 32 are complete ACL tear, 60 are partial ACL tears. Out of total 120 patients meniscal tears are seen in 98 patients and Among 92 patients with ACL tear, 78 patients had associated meniscal tear. Among 120 cases studied only 10 are having posterior cruciate ligament tear
Conclusion: MRI is a non-invasive and accurate technique for examination of the soft tissues and osseous structures of the knee. It has great capability in diagnosing meniscal tears and classifying them into grades and types which would avoid unnecessary arthroscopic examination. It is a very good modality to diagnose complete tears of the ACL. Disadvantages are the limited accuracy in evaluation of hyaline articular cartilage

INTRODUCTION - The posterior cruciate ligament (PCL) is a crucial component that helps keep the knee stable during flexion and rotation. Because the PCL is so robust, avulsion fractures at the PCL's attachment location are common. For complete restoration of PCL function, it is generally believed that avulsion fractures of the PCL should be anatomically reduced and fixed. Conservative therapies usually result in unsatisfactory outcomes, primarily due to functional disability and fracture non-union. Many surgeons think that the displaced or unstable tibial avulsion fracture of the PCL should be reduced and repaired anatomically using various techniques.

Background: Ligamentous injuries to the ligaments and menisci of the knee can lead to significant morbidity and may precipitate osteoarthritis.Arthroscopic diagnosis though invasive is considered as the gold standard. Various imaging modalities like CT scan and MRI have alsobeen used in the diagnosis of these injuries and the quest for the best technique goes on.
Aim: The aim of this study is to assess the diagnostic accuracy of 1.5 T MRI in cases of ligamentous injuries of the knee joint and compare its efficacy with arthroscopy.
Materials & Methods: This is a comparative observational study which included 50 patientswho were clinically suspected to be having ligamentous injuries of the knee. MRI was done for all these patients and all of them laterunderwent arthroscopy in the Department of Orthopaedics-IMCHRC.Statistical analysis was done to derive the sensitivity, specificity, positive predictive value (PPV) and the negative predictive value (NPV) and for this the findings at arthroscopy were taken to be the true diagnosis.
Results: The patients were commonly in the age group of 21-30 years and males with RTA being the commonest mode of injury and duration of injury commonly between 6weeks to 6 months.ACL tear was the commonest injury found in 76% followed by PCL tear in 38% , MM tear in 36%, LM tear in 32%. Regarding the efficacy of 1.5T MRI for ACL tears the sensitivity was 94.6%, specificity 76.9%, PPV 92.1%, NPV 83.3% and accuracy 90%. For PCL it was 94.4%, 93.8%, 89.5%,96.8%,94% respectively. For MM it was 94.7%,100%,100%,96.9%,98% respectively and for LM 83.3%,96.9%.93.9%,91.2%,92% respectively.
Conclusion: MRI is of proven diagnostic value in the evaluation of internal ligamentous injuries of the knee joint. It has a fairly good PPV and its routine use in all clinically suspicious ligamentous injuries of the knee may be recommended. Further since MRI has a high NPV, a normal MRI scan may be used to exclude any pathology and thus avoid an expensive and invasive procedure like arthroscopy.

Aim: The aim of this study to determine the Posterior Cruciate Ligament reconstruction with
peroneus longus tendon graft.
Methods: 12 patients with chronic injury (> 6 months), Presence of an ‘isolated’ PCL were
included in this study. The diagnosis of chronic ligament rupture was established with clinical
examination and imaging (Magnetic resonance imaging, MRI). Post-operative functional
outcome (IKDC, Modified Cincinnati, and Lysholm) were recorded 18 months after surgery
with direct patient examination and a guided-interview by a single orthopaedic surgeon
outside the surgical team.
Results: Mean IKDC score was 48.55±10.69 pre-operatively and 79.88±3 At 18 month’s
follow-up. Mean score of Modified Cincinnati was 49.66±9.69 pre-operatively and
80.69±3.98. Mean Lysholm score was 50.22±10.87 pre-operatively and 81.99±4.59 at 18
months follow-up. Single hop test and triple hop test after 18 months post operatively showed
96.17 ± 2.64 and 92.88 ± 2.67, respectively. Table 3 for the evaluation of donor site
morbidity, ankle functional score is measured with AOFAS and FADI score. The mean of
AOFAS score of donor ankle was 95.61 ± 1.97 and FADI score was 95.89 ± 1.78. Result of
thigh circumference revealed no deference between injury site and contra lateral healthy site
(p > 0.05). The mean circumference in 10 cm proximal to upper patellar bone was
43.55±5.66 at injury site and 44.58±3.69 at contra lateral healthy site. The mean
circumference in 20 cm proximal to upper patellar bone was 50.33±3.96 at injury site and
51.78±4.19 at contra lateral healthy site.
Conclusion: Single bundle PCL reconstruction with peroneus long us tendon auto graft had
improvement functional outcome (IKDC, Modified Cincinnati, Lysholm) and shown
excellent ankle function and serial hop test result at 18 months evaluation