[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-449303-105":59,"doc-detail-449303-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","diagnostic-accuracy-and-reliability-of-dynamic-handheld-ultrasound-testing-in-detecting-anterior-cruciate-ligament-tears-a-cadaveric-study","Diagnostic Accuracy and Reliability of Dynamic Handheld Ultrasound Testing in Detecting Anterior Cruciate Ligament Tears: A Cadaveric Study","","Objectives: Anterior cruciate ligament (ACL) injuries may be missed at initial evaluation, and delayed diagnosis can lead to knee instability and an increased risk of osteoarthritis. Methods: Ten fresh-frozen knee specimens were assessed in three conditions (intact ACL, complete ACL deficiency, and ACL plus anterolateral ligament deficiency) using portable handheld ultrasound while simulating Lachman and pivot shift tests. Receiver operating characteristic analysis was used to determine diagnostic cutoff values, and intra- and inter-observer reliability were calculated. Results and Conclusion: From an anterior medial view, ultrasound-measured tibial anterior translation increased in deficient conditions, with high area under ROC and sensitivity/specificity.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/diagnostic-accuracy-and-reliability-of-dynamic-handheld-ultrasound-testing-in-detecting-anterior-cruciate-ligament-tears-a-cadaveric-study/449303/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/diagnostic-accuracy-and-reliability-of-dynamic-handheld-ultrasound-testing-in-detecting-anterior-cruciate-ligament-tears-a-cadaveric-study/449303.png","ImageObject",300,407,{"name":92,"@type":93},"Ben ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-09","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What was the main objective of the study?","Question",{"text":113,"@type":114},"To evaluate whether dynamic testing using portable handheld ultrasound can accurately detect ACL insufficiency, with high diagnostic accuracy and reliability.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were the knee conditions simulated during ultrasound testing?",{"text":118,"@type":114},"Ten fresh-frozen specimens were tested under three conditions: intact ACL, complete ACL deficiency, and ACL plus anterolateral ligament deficiency, while simulating Lachman and pivot shift maneuvers.",{"name":120,"@type":111,"acceptedAnswer":121},"What diagnostic performance was reported from the anterior medial (AM) ultrasound view?",{"text":122,"@type":114},"The AM view showed significantly increased tibial anterior translation under anterior loading in ACL-deficient and ACL+ALL-deficient conditions, with an ROC area of 0.89 for identifying ACL deficiency and an optimal cutoff of 2.6 mm (sensitivity 80%, specificity 90%).","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},449303,1790966390,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":46,"preview_page_count":4},2336478951081,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","RESEARCH ARTICLE  \nDiagnostic Accuracy and Reliability of Dynamic Handheld Ultrasound Testing in Detecting Anterior Cruciate Ligament Tears: A Cadaveric Study  \nYuzuru Sakakibara, MD, PhD; Vasundhara Mathur, MBBS; David O. Osei-Hwedieh, MD, PhD; Rohan Bhimani, MD; Atta Taseh, MD; Soheil Ashkani-Esfahani, MD; Miho J. Tanaka, MD  \nResearch performed at Massachusetts General Hospital, Boston, Massachusetts, USA  \nReceived: 2 May 2025 Accepted: 13 September 2025  \nAbstract  \nObjectives: Anterior cruciate ligament (ACL) injuries can go undetected in the initial encounter, and delayed diagnosis can cause instability and an elevated risk of osteoarthritis. We hypothesized that dynamic testing under handheld ultrasound assessments of ACL insufficiency offers high diagnostic accuracy and reliability.  \nMethods: Ten fresh-frozen knee specimens were evaluated in three conditions: (1) intact ACL,(2) complete ACL deficiency, and (3) ACL and Anterolateral ligament (ALL) deficiency. Dynamic testing under ultrasound was performed while simulating the Lachman test (tibial anterior translation with 0 and 100N, at 20 degrees knee flexion) and pivot shift test (internal rotation torque with 0 and 10Nm) . The probe was placed at the anterior medial (AM) and lateral (AL) joint line, and anterior translation of the tibia (ΔD) relative to the femur was calculated. Intra-observer and inter-observer reliability were calculated, and receiver operating characteristic (ROC) curve analysis was performed for an ideal cutoff point for detecting knee instability.  \nResults: From the AM view, ACL-deficient and ACL+ALL-deficient conditions significantly increased ΔD of the tibia during anterior loading compared to the intact ACL condition. The median ΔD values of the tibia in AM view with anterior drawer load were 0.64 (-0.10, 2.67) mm (intact ACL), 4.76 (2.46, 7.21) mm (ACL deficiency), and 3.88 (2.08, 7.23) mm (ACL+ALL deficiencies) . The area under the ROC curve identifying ACL deficiency was 0.89 (95%CI, 0.66-0.97) in the AM view with anterior loading simulating the Lachman test. The optimal cut-off value to distinguish between the intact and ACL-deficient condition for anterior tibial translation with loading was 2.6 mm (sensitivity=80%, specificity=90%) .  \nConclusion: Dynamic examination of the knee using portable handheld ultrasound from an AM view has high sensitivity and specificity in diagnosing ACL injury.  \nLevel of evidence: V  \nKeywords: ACL , Athletic injuries , Injuries , Knee instability , Lachman test , Ultrasonography  \nIntroduction  \nA nterior cruciate ligament (ACL) injuries are one of  \nthe most common knee injuries evaluated by sports medicine specialists, with over 200,000 cases occurring annually in the United States alone. 1,2 If left unrecognized and untreated, ACL injuries can contribute to functional impairment as well as result in damage to themeniscus and the articular cartilage, thereby increasing the  \npatient’s risk of developing osteoarthritis.3-9 Therefore, timely detection and confirmation allow for prompt management and discussion of treatment options.4,10 ACL injuries can go undetected, even though many patients present with pain early after the initial injury, and additional imaging studies, including magnetic resonance imaging (MRI), are recommended for a more accurate  \nassessment and confirmation of ligament injuries. MRI utilization during the initial patient encounter is further limited by unavailability in resource-poor settings, excessive cost, and time required to undergo the study.11 In addition, MRI cannot assess ACL function and the dynamic stability of the knee. This necessitates the search for more accessible, accurate imaging methods that can assist clinicians in the dynamic examination of the knee.  \nThe Lachman test, pivot shift test, and anterior drawer test have been described as important dynamic assessments during physical examination to detect ACL injuries.12The Lachman test has been reported to have","cbCaiv0gW7K00kE5","https://ap.wps.com/l/cbCaiv0gW7K00kE5","pdf",1073076,"English","# Abstract\n## Objectives\n## Methods\n## Results\n## Conclusion\n# Introduction\n## Clinical need for dynamic assessment\n## Limitations of physical tests and MRI\n## Role and challenges of ultrasound\n## Study rationale","[{\"question\":\"What was the main objective of the study?\",\"answer\":\"To evaluate whether dynamic testing using portable handheld ultrasound can accurately detect ACL insufficiency, with high diagnostic accuracy and reliability.\"},{\"question\":\"How were the knee conditions simulated during ultrasound testing?\",\"answer\":\"Ten fresh-frozen specimens were tested under three conditions: intact ACL, complete ACL deficiency, and ACL plus anterolateral ligament deficiency, while simulating Lachman and pivot shift maneuvers.\"},{\"question\":\"What diagnostic performance was reported from the anterior medial (AM) ultrasound view?\",\"answer\":\"The AM view showed significantly increased tibial anterior translation under anterior loading in ACL-deficient and ACL+ALL-deficient conditions, with an ROC area of 0.89 for identifying ACL deficiency and an optimal cutoff of 2.6 mm (sensitivity 80%, specificity 90%).\"}]","Diagnostic Accuracy and Reliability of Dynamic Handheld Ultrasound Testing in Detecting Anterior Cruciate Ligament Tears: A Cadaveric Study | PDF",1790729803]