The patellar tendon wavy sign as a new secondary sign of ACL tear on MRI

Objective: The purpose of this study was to evaluate the diagnostic value of the patellar tendon wavy (PTW) sign for an anterior cruciate ligament (ACL) tear on MRI. Methods: One hundred MRI scans were prospectively analyzed, with 50 patients with an ACL tear underwent an ACL reconstruction (group 1...

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Main Authors: Huijun Kang, Kunpeng Fu, Conglei Dong, Fei Wang
Format: Article
Language:English
Published: AVES 2018-09-01
Series:Acta Orthopaedica et Traumatologica Turcica
Online Access:http://www.sciencedirect.com/science/article/pii/S1017995X1830004X
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author Huijun Kang
Kunpeng Fu
Conglei Dong
Fei Wang
author_facet Huijun Kang
Kunpeng Fu
Conglei Dong
Fei Wang
author_sort Huijun Kang
collection DOAJ
description Objective: The purpose of this study was to evaluate the diagnostic value of the patellar tendon wavy (PTW) sign for an anterior cruciate ligament (ACL) tear on MRI. Methods: One hundred MRI scans were prospectively analyzed, with 50 patients with an ACL tear underwent an ACL reconstruction (group 1) and 50 patients with knee complaints other than ACL tear (group 2). The PTW sign was confirmed on the sagittal MRI. In addition, the patellar tendon length, tibial-femoral angle and tibial anterior translation (TAT) were compared between the groups. Results: The PTW sign was present in 41/50 (82%) MRI scans in group 1 and 10/50 (20%) in group 2, with significant difference between two groups (p = 0.000). Significant differences were also found, in medial TAT (6.29 ± 3.25 mm versus 3.12 ± 2.85 mm) and in lateral TAT (7.62 ± 3.85 mm versus 1.58 ± 3.93 mm) between two groups (both p = 0.000). Comparison of MRI with and without PTW sign, ACL injury was found to be of significant difference with 41/51 (80.4%) versus 9/49 (18.4%) (p = 0.000), and both medial and lateral TAT were with significant differences, 5.39 ± 3.90 mm versus 3.99 ± 2.71 mm (p = 0.039) and 7.67 ± 3.77 mm versus 1.40 ± 3.81 mm (p = 0.000), respectively. The sensitivity and specificity of PTW sign were 82% and 80%. The positive and negative predictive value were 80.4% and 81.6%. The diagnosis accuracy was 81%. Conclusion: The PTW sign is a useful secondary MRI sign to establish the diagnosis of an ACL tear. It may be associated with the TAT secondary to an ACL tear. Level of evidence: Level III, diagnostic study. Keywords: Anterior cruciate ligament, MRI diagnosis, Secondary sign, Patellar tendon wavy sign, Tibial anterior translation
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spelling doaj.art-162f5f27d4cf401ca09e86968317e74b2023-02-15T16:10:14ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2018-09-01525372375The patellar tendon wavy sign as a new secondary sign of ACL tear on MRIHuijun Kang0Kunpeng Fu1Conglei Dong2Fei Wang3Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, ChinaCorresponding author. No. 139 Ziqiang Road, Shjiazhuang, 050051, Hebei, China. Tel.: +86 311 88602013.; Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, ChinaObjective: The purpose of this study was to evaluate the diagnostic value of the patellar tendon wavy (PTW) sign for an anterior cruciate ligament (ACL) tear on MRI. Methods: One hundred MRI scans were prospectively analyzed, with 50 patients with an ACL tear underwent an ACL reconstruction (group 1) and 50 patients with knee complaints other than ACL tear (group 2). The PTW sign was confirmed on the sagittal MRI. In addition, the patellar tendon length, tibial-femoral angle and tibial anterior translation (TAT) were compared between the groups. Results: The PTW sign was present in 41/50 (82%) MRI scans in group 1 and 10/50 (20%) in group 2, with significant difference between two groups (p = 0.000). Significant differences were also found, in medial TAT (6.29 ± 3.25 mm versus 3.12 ± 2.85 mm) and in lateral TAT (7.62 ± 3.85 mm versus 1.58 ± 3.93 mm) between two groups (both p = 0.000). Comparison of MRI with and without PTW sign, ACL injury was found to be of significant difference with 41/51 (80.4%) versus 9/49 (18.4%) (p = 0.000), and both medial and lateral TAT were with significant differences, 5.39 ± 3.90 mm versus 3.99 ± 2.71 mm (p = 0.039) and 7.67 ± 3.77 mm versus 1.40 ± 3.81 mm (p = 0.000), respectively. The sensitivity and specificity of PTW sign were 82% and 80%. The positive and negative predictive value were 80.4% and 81.6%. The diagnosis accuracy was 81%. Conclusion: The PTW sign is a useful secondary MRI sign to establish the diagnosis of an ACL tear. It may be associated with the TAT secondary to an ACL tear. Level of evidence: Level III, diagnostic study. Keywords: Anterior cruciate ligament, MRI diagnosis, Secondary sign, Patellar tendon wavy sign, Tibial anterior translationhttp://www.sciencedirect.com/science/article/pii/S1017995X1830004X
spellingShingle Huijun Kang
Kunpeng Fu
Conglei Dong
Fei Wang
The patellar tendon wavy sign as a new secondary sign of ACL tear on MRI
Acta Orthopaedica et Traumatologica Turcica
title The patellar tendon wavy sign as a new secondary sign of ACL tear on MRI
title_full The patellar tendon wavy sign as a new secondary sign of ACL tear on MRI
title_fullStr The patellar tendon wavy sign as a new secondary sign of ACL tear on MRI
title_full_unstemmed The patellar tendon wavy sign as a new secondary sign of ACL tear on MRI
title_short The patellar tendon wavy sign as a new secondary sign of ACL tear on MRI
title_sort patellar tendon wavy sign as a new secondary sign of acl tear on mri
url http://www.sciencedirect.com/science/article/pii/S1017995X1830004X
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