[Diagnosis of fresh combined injuries of the knee ligaments (clinical and technical diagnosis)]

Abstract

Detailed information about the cause of the accident, possible previous injuries and a meticulous clinical examination are essential for a correct diagnosis. The Lachman test has been demonstrated to detect an ACL injury. Its reliability however is dependent on avoiding an inappropriate internal rotation and may be curtailed by voluminous musculature and a bucket-handle tear. Reproducible testing of the pivot shift can be carried out only under anaesthesia. Magnetic resonance imaging (MRI) is of high diagnostic validity in acute ACL injuries. With the aid of arthroscopy even partial tears of the ACL, chondral lesions and injuries of the dorsal parts of the joint are detected. Sometimes prior to an arthrotomy diagnostic and therapeutic arthroscopy are combined.