[The diagnostic certainty of various methods of evaluating recent trauma to knee ligaments]

The prognosis of knee ligament injury is mainly dependent on early diagnosis. In a prospective trial comprising 108 patients with fresh injury of the knee ligaments, the prognostic value of clinical non-invasive examination were assessed in awake and anesthetized patients. As a result the merely clinical examination without anesthesia gave only in 48% a diagnosis reliably enough for operation indication. Examination under anesthesia detected more than 83% of injuries with need for operation and 90% of ruptures of the anterior cruciate ligament. Lachman-test proved to be very reliable (more than 90%) and lateral pivot-shift-phenomenon almost provable (more than 86%) for ligament rupture. Arthroscopy in our hands is playing only a minor role at the event of fresh injury of the knee ligaments. In only 10% it was the decisive tool for operation. In our opinion the indication for narcosis examination should be put widely due to its high sensitivity. Since in approximately 90% on additional arthroscopy can be resigned, the entire ischemia time during pneumatic blood circulation blockage (110 to 120 min) is available for operative reconstruction of the knee joint.