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8 Appendix A
Ligament Injury Diagnosis and Treatment
Clinical Considerations
Ligament damage constitutes an important part of traumatic and athletic injuries and is
frequently associated with internal derangement of the joint. Initial work-up is aimed at
excluding osteochondral fractures, dislocations and neuro-vascular involvement,
followed by an assessment of ligament injury. Information on the extent of ligament
damage is important because, in practice, this determines the treatment of choice,
whether to treat conservatively or consider surgery. In conservatively managed injuries,
the extent of initial ligament damage ultimately determines prognosis and time to
recover.
The work-up of ligament injury routinely involves a physical examination, x-rays and, on
occasion, stress radiography, MRI, arthrography or arthroscopy. Each of these
diagnostic tools has its own intrinsic value and thus contributes to the total assessment
of the ligament injury. However, it is evident that each examination also markedly adds
to total cost.
The LIGMASTER™ procedure combines speed and non-invasiveness with reliability and
safety. It has, moreover, a unique advantage over all other techniques in that it provides
direct information on the extent of ligament damage in terms of percentage functional
loss (or recovery) that is critical to the decision making process.
LIGMASTER™ has been designed to operate using ligament stress devices that have a
long clinical history of safety and reliability. As a result, some of the limitations of these
devices are shared by LIGMASTER™: Stress exams provide information on ligaments
only and cannot exclude other injuries such as osteochondral fractures or meniscal
tears that may accompany ligament damage. As is the proper procedure with
conventional stress studies, associated injury, if suspected, may need to be excluded
before proceeding with LIGMASTER™ after the initial injury. All subsequent stress exams
can then be done safely with LIGMASTER™ alone.
Two major features set LIGMASTER™ apart from conventional stress devices:
1- There is no need to take X-rays for the determination of the talar tilt angle, the
anterior/posterior drawer of the knee, elbow joint widening or shoulder subluxation.
This has the important consequence that stress exams no longer require a hospital
setting including appointments, radiology facilities/personnel and patient exposure to
ionizing radiation. Instead, the stress exam can be performed by qualified athletic
trainers, coaches, office nurses and paramedics requiring only minimal computer
skills. As a result, a more liberal use of stress exams and stress devices has
become feasible.
2- Unlike conventional stress exams that yield information on joint laxity only,
LIGMASTER™ provides full details on the extent of ligament tear using the graded
stress technique (GST). This technique can distinguish complete rupture from partial
LigMaster™ User’s Manual - Sport Tech Inc.
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