Table 2.
Description of studies analyzing medial collateral ligament injury with ultrasonography
| References | Patient knees/control group | Age (mean, range) | Medial joint space opening | Morphological findings | Intraobserver/interobserver reliability | Sensitivity (%)/specificity (%) | PPV/NPV |
|---|---|---|---|---|---|---|---|
| De Flaviis et al. 1988 (PS) [43] | 10/– | n.r |
Grade I rupture (n = 3): 7.0–10.0 mm Grade II rupture (n = 3): 9.0–18.0 mm Grade III rupture (n = 4): 12.0–23.0 mm |
Grade I rupture: intraarticular hemorrhage Grade II rupture: inhomogenity of the ligament without a clear cut Grade III rupture: irregular hypoechoic fissure |
n.r | n.r | n.r |
| Friedl et al. 1991 (PS) [42] | 84/– | 32, n.r |
No rupture (n = 21): 2.9 ± 1.4 mm Partial rupture (n = 9): 5.2 ± 1.3 mm Complete rupture (n = 54): 6.6 ± 1.6 mm |
n.r | n.r | 63–87/96a | 63–94/80 |
| Lee et al. 1996 (PS) [36] | 16/20 |
32, 21–52 control group: n.r., 23–28 |
n.r |
Injured MCL (n = 16): “thickened, heterogenous hypoechoic lesion on the tender points” Attachment thickness: femoral 8.3 mm (6.1–12.5 mm), tibial 3.9 mm (3.7–4.1 mm) Normal MCL (n = 20): “homogenous hypoechotic band” Attachment thickness: femoral 4.3 mm (3.3–5.6 mm), tibial 2.3 mm (1.3–3.2 mm) |
n.r | n.r | n.r |
| Ghosh et al. 2017 (PS) [27] | 9/– | 53, n.r | n.r |
grade I rupture (n = 2): “stretching of the ligament without discontinuity of the fibers and associated edematous changes” Old rupture (n = 1): “Thickening of proximal MCL Normal MCL (n = 6): “thick hyperechoic and fibrillar structure, extending from the medial femoral condyle to the proximal tibia” |
n.r | 67/83b | 67/83 |
| Slane et al. 2017 (CS) [52] | –/8 | n.r., 68–101 |
Unloaded: 8.7 ± 2.4 mm Loaded (10 Nm valgus): 10.7 ± 2.2 mm |
n.r |
n.r./ Unloaded: 0.95 Loaded: 0.93 |
n.r | n.r |
| Lutz et al. 2020 (PS) [44] | –/79 | 35, 20–63 |
Unloaded 0°: 5.7 ± 1.2 mm Loaded 0°: 7.4 ± 1.4 mm Unloaded 30°: 6.1 ± 1.1 mm Loaded 30°: 7.8 ± 1.2 mm |
n.r |
n.r./ ICCs: loaded and unloaded 0.89 |
n.r | n.r |
CS cadaveric study, ICC intra-class correlation coefficient, MCL medial collateral ligament, NPV negative predictive value, n.r not reported, PPV positive predictive value, PS prospective study
aClinical examination, examination under anaesthesia, arthroscopy, and operative findings
bMRI