Reliability in the Detection of ACL Injuries in Emergency Departments
Conditions
Keywords
ACL (anterior cruciate ligament)
Brief summary
A screening score for ACL (anterior cruciate ligament) injuries based on questioning has been developed by the Société Francophone d'Arthroscopie to provide better guidance for post-trauma patients. The score differentiates between 3 groups of patients: mild trauma (score 1 to 4), intermediate trauma (score 5 to 7) and severe trauma (score 8 to 12). The main hypothesis of this study is that it is a reliable score for detecting ACL injuries in emergency departments.
Detailed description
Injury to the anterior cruciate ligament is a serious and not uncommon event, which can affect the functional future of the knee. The result is instability, leading to meniscal and osteo-cartilaginous damage in the medium and long term. Early diagnosis would limit the occurrence of these complications. The average annual incidence of ACL rupture in the French population is estimated at around population can be estimated at around 0.03%, or approximately 20,000 cases per year. Diagnosis is currently based on clinical examination and dynamic ligament testing. However, these may be difficult to perform in the immediate post-trauma period, leading to a delay in diagnosis. Magnetic resonance imaging (MRI) is a good diagnostic tool, with a sensitivity of 83-95% and a specificity of 95-100%. However, access to MRI is still limited in emergencies, with an average appointment time (all indications combined) of 32.3 days. It is therefore to better target the indications for this examination. The Société Francophone d'Arthroscopie has developed a screening score for ACL lesions, based on questioning, to help guide post-trauma patients.
Interventions
DIAGNOSTIC_TESTExternal validity of the SFA score
Testing the external validity of the SFA score for the detection of in adult emergency departments
Sponsors
University Hospital, Rouen
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* All patients presenting to adult emergency departments with knee trauma less than 9 days old; * All patients aged between 18 and 55; * All patients without an X-ray fracture (with the exception of indirect signs of injury to the central pivot: Segond's fracture and avulsion of the tibial spines); * All patients affiliated to or benefiting from a social security scheme; * All patients who have given their and who have received a study information sheet.
Exclusion criteria
* Trauma requiring immediate surgical treatment (fracture, dislocation); * Previous osteoarticular trauma to the knee; * Pregnant women; * Impossible to carry out an MRI (contraindication, refusal, claustrophobia); * Impossible to provide follow-up in the same centre; * Protected patients: adults under guardianship, curatorship or other legal protection, deprived of liberty by judicial or administrative decision.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| External validity of the SFA score | At enrollment visit, Month 1 | Testing the external validity of the SFA score for the detection of in adult emergency departments |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity of the different score items (functional impotence > 1) | At enrollment visit, Month 1 | Analyse the sensitivity of the functional impotence score for screening for ACL injuries (functional impotence \> 1) |
| Sensitivity of the different score items (Cracking ≥ 1) | At enrollment visit, Month 1 | Analyse the sensitivity of the Cracking score for screening for ACL injuries (Cracking ≥ 1) |
| Sensitivity of the different score items (Instability ≥ 1) | At enrollment visit, Month 1 | Analyse the sensitivity of the Instability score for screening for ACL injuries (Instability ≥ 1) |
| Sensitivity of the different score items (Presence of an effusion) | At enrollment visit, Month 1 | Analyse the sensitivity of the effusion score for screening for ACL injuries (Presence of an effusion) |
| Sensitivity of the different score items (EVA > 6) | At enrollment visit, Month 1 | Analyse the sensitivity of the EVA score for screening for ACL injuries (EVA \> 6) |
| Specificity of the different score items (functional impotence > 1) | At enrollment visit, Month 1 | Analyse the Specificity of the functional impotence score for screening for ACL injuries (functional impotence \> 1) |
| Specificity of the different score items (Cracking ≥ 1) | At enrollment visit, Month 1 | Analyse the Specificity of the Cracking score for screening for ACL injuries (Cracking ≥ 1) |
| Specificity of the different score items (Instability ≥ 1) | At enrollment visit, Month 1 | Analyse the Specificity of the Instability score for screening for ACL injuries (Instability ≥ 1) |
| Specificity of the different score items (Presence of an effusion) | At enrollment visit, Month 1 | Analyse the Specificity of the effusion score for screening for ACL injuries (Presence of an effusion) |
| Specificity of the different score items (EVA > 6) | At enrollment visit, Month 1 | Analyse the Specificity of the EVA score for screening for ACL injuries (EVA \> 6) |
Countries
France
Outcome results
None listed