Time from Injury Is the Key Predictor of Meniscal Injury in ACL-Deficient Knees

AbstractThe meniscus is one of the most important structures of the knee that needs to be saved if possible. Previous studies showed that increasing time from an anterior cruciate ligament (ACL) injury (TFI) could lead to a meniscal tear, especially medial meniscus (MM). We developed the present study to see if the TFI alone is a predictor of meniscal injury in ACL-deficient knees. We included 111 patients who had a reconstructed ACL injury at our institution from March 2015 to March 2016 in this retrospective cohort study. All demographic data, including age, gender, and body mass index (BMI), were collected. We also recorded the mechanism of injury and the TFI. We extracted the meniscal condition at the time of surgery from the surgical report. All patients were followed up for a mean of 23 months, and the Lysholm score and pain visual analog scale (VAS) score were obtained. The mean TFI of patients with MM tear was 17.4 ± 16.8 months, which was significant than the patients with lateral meniscal (LM) tear (9.3 ± 8.3 months) and intact meniscus (7.4 ± 8.1 months) (p = 0.001). Patients with TFI less than 6 months had a significantly lower rate of MM tear, and increasing TFI more than 6 months could increase the rate of MM tear (p = 0.001). We could not find any association between age, BMI, and gender and meniscal injury. At the latest follow-up, Lysholm and VAS scores in patients with and without meniscal tear were the same. Our study confirms that increasing time from the ACL injury would increase the risk of MM damage. The cutoff point for this risk factor is 6 months from initial injury; therefore, to save the meniscus, it might be better to perform ACL reconstruction within 6 months in ACL-deficient knees.

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Correlation of Meniscal Tear with Timing of Anterior Cruciate Ligament Reconstruction in Patients without Initially Concurrent Meniscal Tear

The Journal of Knee Surgery ◽

10.1055/s-0038-1675783 ◽

2018 ◽

Vol 32 (11) ◽

pp. 1128-1132

Author(s):

Kun-Hui Chen ◽

En-Rung Chiang ◽

Hsin-Yi Wang ◽

Hsiao-Li Ma

Keyword(s):

Medial Meniscus ◽

Cruciate Ligament ◽

Meniscal Tear ◽

Lateral Meniscus ◽

Acl Injury ◽

Meniscus Tear ◽

Meniscal Tears ◽

Anterior Cruciate ◽

Late Group ◽

Acl Deficient

AbstractThe incidence of meniscal tear was reported to increase with the delay of anterior cruciate ligament reconstruction (ACLR). The tear may occur concurrently with the ACL injury or after the ACL injury. Few studies had focused on the patients whose meniscus is intact during ACL injury. We determined the correlation between timing of surgery and incidence of meniscal tears in ACL-deficient knees with initially intact meniscus. We retrospectively reviewed 387 patients who had undergone primary ACLR. Time of initial ACL injury, magnetic resonance imaging (MRI) examination, and surgery was recorded. The MRI was reviewed by experienced radiologic and orthopaedic doctors. Intraoperative arthroscopic images were also obtained and reviewed. The type of tear noted during surgery was classified according to the modification of International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine classification of meniscal tears. Patients were divided into early (surgery within 12 months from injury) and late surgery group (surgery at more than 12 months from injury). There were 216 patients with intact medial meniscus and 257 patients with intact lateral meniscus on the postinjury MRI study. The incidence of medial meniscus tear (MMT) was significantly higher than lateral meniscus tear (LMT) during the ACLR (33.8 vs. 19.8%, p < 0.001). The incidence of MMT is higher in late group than in early group (53.7 vs. 29.1%, p = 0.004, odds ratio= 2.815). The incidence of LMT is mildly higher in late group but without statistics significance (23.8 vs. 18.6%, p = 0.364). In both MMT and LMT, the most common injury pattern observed was a longitudinal tear. The incidence of each type is not different between early and late group. For patients without concurrent meniscal injuries with the ACL tear, the incidence of MMT significantly increased if ACLR was performed more than 12 months after injury. The medial meniscus was more prone to injury than the lateral meniscus in chronic ACL-deficient knee. ACLR should be performed earlier to reduce the risk of meniscal tears for patients without initially concurrent meniscal tear.

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EFFECT OF SKELETAL MATURITY ON INCIDENCE OF ASSOCIATED MENISCAL AND CHONDRAL INJURIES IN ANTERIOR CRUCIATE LIGAMENT INJURED KNEES

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00105 ◽

2021 ◽

Vol 9 (7_suppl3) ◽

pp. 2325967121S0010

Author(s):

Brett Heldt ◽

Elsayed Attia ◽

Raymond Guo ◽

Indranil Kushare ◽

Theodore Shybut

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Medial Meniscus ◽

Skeletal Maturity ◽

Cruciate Ligament ◽

Demographic Data ◽

Meniscal Tear ◽

Lateral Meniscus ◽

Meniscus Tears ◽

Anterior Cruciate

Background: Acute anterior cruciate ligament(ACL) rupture is associated with a significant incidence of concomitant meniscal and chondral injuries. However, to our knowledge, the incidence of these concomitant injuries in skeletally immature(SI) versus skeletally mature(SM) patients has not been directly compared. SI patients are a unique subset of ACL patients because surgical considerations are different, and subsequent re-tear rates are high. However, it is unclear if the rates and types of meniscal and chondral injuries differ. Purpose: The purpose of this study is to compare associated meniscal and chondral injury patterns between SI and SM patients under age 21, treated with ACL reconstruction for an acute ACL tear. We hypothesized that no significant differences would be seen. Methods: We performed a single-center retrospective review of primary ACL reconstructions performed from January 2012 to April 2020. Patients were stratified by skeletal maturity status based on a review of records and imaging. Demographic data was recorded, including age, sex, and BMI. Associated intra-articular meniscal injury, including laterality, location, configuration, and treatment were determined. Articular cartilage injury location, grade, and treatments were determined. Revision rates, non-ACL reoperation rates, and time to surgery were also compared between the two groups. Results: 785 SM and 208 SI patients met inclusion criteria. Mean BMI and mean age were significantly different between groups. Meniscal tear rates were significantly greater in SM versus SI patients in medial meniscus tears(P<.001), medial posterior horn tears(P=.001), medial longitudinal tears configuration(P=.007), lateral Radial configuration(P=.002), and lateral complex tears(P=.011). Medial repairs(P<.001) and lateral partial meniscectomies(P=.004) were more likely in the SM group. There was a significantly greater number of chondral injuries in the SM versus SI groups in the Lateral(p=.007) and medial compartments(P<.001). SM patients had a significantly increased number of outerbridge grade 1 and 2 in the Lateral(P<.001) and Medial Compartments(P=.013). ACL revisions(P=.019) and Non-ACL reoperations(P=.002) were significantly greater in the SI patients compared to SM. No other significant differences were noted. Conclusion: SM ACL injured patients have a significantly higher rate of medial meniscus tears and medial longitudinal configurations treated with repair, and a significantly higher rate of radial and/or complex lateral meniscus tears treated with partial meniscectomy compared to the SI group. We also found a significantly higher rate of both medial and lateral compartment chondral injuries, mainly grades 1 and 2, in SM compared to SI patients. Conversely, SI ACL reconstruction patients had higher revision and subsequent non-ACL surgery rates.

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Which factors are associated with the prevalence of meniscal repair?

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04107-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Xiaoxiao Song ◽

Dongyang Chen ◽

Xinsheng Qi ◽

Qing Jiang ◽

Caiwei Xia

Keyword(s):

Cruciate Ligament ◽

Demographic Data ◽

Meniscal Tear ◽

Univariate Analysis ◽

Lateral Meniscus ◽

Meniscal Repair ◽

Acl Injury ◽

Partial Meniscectomy ◽

Meniscus Tear ◽

Confounding Factors

Abstract Purpose To investigate the potential factors associated with the prevalence of meniscal repair Methods Patients who received partial meniscectomy or meniscal repair in our institution from Jan 2015 to Dec 2019 were included in current study. The inclusion criteria were (1) meniscus tear treated using meniscectomy or repair, (2) with or without concomitant anterior cruciate ligament reconstruction, (3) not multiligamentous injury. Demographic data, including sex, age, body mass index (BMI), injury-to-surgery interval and intra-articular factors such as the location of injury, medial or lateral, ACL rupture or not and the option of procedure (partial meniscectomy or repair) were documented from medical records. Univariate analysis consisted of chi-square. Multivariate logistic regression was then performed to adjust for confounding factors. Results 592 patients including 399 males and 193 females with a mean age of 28.7 years (range from 10 to 75 years) were included in current study. In the univariate analysis, male (p = 0.002), patients aged 40 years or younger (p < 0.001), increased weight (p = 0.010), Posterior meniscus torn (0.011), concurrent ACL ruputure (p < 0.001), lateral meniscus (p = 0.039) and early surgery (p < 0.001) were all associated with the prevalence of meniscal repair. However, After adjusting for confounding factors, we found that age (OR, 0.35; 95% CI, 0.17 - 0.68, p = 0.002), ACL injury (OR, 3.76; 95% CI, 1.97 – 7.21, p < 0.001), side of menisci (OR, 3.29; 95% CI, 1.43 – 7.55, p = 0.005), site of tear (OR, 0.15; 95% CI, 0.07 – 0.32, p < 0.001), and duration of injury (OR, 0.46; 95% CI, 0.28 – 0.82, p = 0.008) were associated with the prevalence of meniscus repair. Conclusions Meniscal tear in aged patients especially those with concomitant ACL injury is likely to be repaired. Additionally, in order to increase the prevalence of repair and slow down progression of OA, the surgical procedure should be performed within two weeks after meniscus tear especially when the tear is located at lateral meniscal posterior. Study design Case-control study; level of evidence, 3.

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Nonsurgical Management of an Anterior Cruciate Ligament-Deficient Knee in a Women's Soccer Player: A Validation Clinical Case Report

Journal of Athletic Training ◽

10.4085/1062-6050.52.11.21 ◽

2017 ◽

Vol 52 (11) ◽

pp. 1079-1083

Author(s):

Courtney E. Gray ◽

Chris Hummel ◽

Todd Lazenby

Keyword(s):

Randomized Controlled Trial ◽

Anterior Cruciate Ligament ◽

Case Report ◽

Soccer Player ◽

Controlled Trial ◽

Cruciate Ligament ◽

Meniscal Tear ◽

Randomized Controlled ◽

Anterior Cruciate ◽

Acl Deficient

Background: A collegiate women's soccer player sustained an isolated anterior cruciate ligament (ACL) tear and expressed a desire to continue her season without surgical intervention. Design: Case report. Intervention(s): Using the results of a randomized controlled trial and published clinical guidelines, the clinicians classified the patient as an ACL-deficient coper. The patient completed her soccer season without incident, consistent with the findings of the established clinical guidelines. However, 6 months later, she sustained a meniscal tear, which was not unexpected given that 22% of ACL-deficient copers in the randomized controlled trial incurred a meniscal tear within 24 months of ACL injury. Conclusion: The external evidence was helpful in making informed clinical decisions regarding patient care.

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Effects of Anterior Cruciate Ligament Deficiency on Tibiofemoral Cartilage Thickness and Strains in Response to Hopping

The American Journal of Sports Medicine ◽

10.1177/0363546518802225 ◽

2018 ◽

Vol 47 (1) ◽

pp. 96-103 ◽

Cited By ~ 8

Author(s):

E. Grant Sutter ◽

Betty Liu ◽

Gangadhar M. Utturkar ◽

Margaret R. Widmyer ◽

Charles E. Spritzer ◽

...

Keyword(s):

Cruciate Ligament ◽

Acl Injury ◽

Cartilage Thickness ◽

Intercondylar Notch ◽

Dynamic Activity ◽

Acl Deficiency ◽

Anterior Cruciate ◽

Acl Deficient ◽

Deficient Knee

Background: Changes in knee kinematics after anterior cruciate ligament (ACL) injury may alter loading of the cartilage and thus affect its homeostasis, potentially leading to the development of posttraumatic osteoarthritis. However, there are limited in vivo data to characterize local changes in cartilage thickness and strain in response to dynamic activity among patients with ACL deficiency. Purpose/Hypothesis: The purpose was to compare in vivo tibiofemoral cartilage thickness and cartilage strain resulting from dynamic activity between ACL-deficient and intact contralateral knees. It was hypothesized that ACL-deficient knees would show localized reductions in cartilage thickness and elevated cartilage strains. Study Design: Controlled laboratory study. Methods: Magnetic resonance images were obtained before and after single-legged hopping on injured and uninjured knees among 8 patients with unilateral ACL rupture. Three-dimensional models of the bones and articular surfaces were created from the pre- and postactivity scans. The pre- and postactivity models were registered to each other, and cartilage strain (defined as the normalized difference in cartilage thickness pre- and postactivity) was calculated in regions across the tibial plateau, femoral condyles, and femoral cartilage adjacent to the medial intercondylar notch. These measurements were compared between ACL-deficient and intact knees. Differences in cartilage thickness and strain between knees were tested with multiple analysis of variance models with alpha set at P < .05. Results: Compressive strain in the intercondylar notch was elevated in the ACL-deficient knee relative to the uninjured knee. Furthermore, cartilage in the intercondylar notch and adjacent medial tibia was significantly thinner before activity in the ACL-deficient knee versus the intact knee. In these 2 regions, thinning was significantly influenced by time since injury, with patients with more chronic ACL deficiency (>1 year since injury) experiencing greater thinning. Conclusion: Among patients with ACL deficiency, the medial femoral condyle adjacent to the intercondylar notch in the ACL-deficient knee exhibited elevated cartilage strain and loss of cartilage thickness, particularly with longer time from injury. It is hypothesized that these changes may be related to posttraumatic osteoarthritis development. Clinical Relevance: This study suggests that altered mechanical loading is related to localized cartilage thinning after ACL injury.

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Secondary Meniscal Tears in Patients With Anterior Cruciate Ligament Injury: Relationship Among Operative Management, Osteoarthritis, and Arthroplasty at 18-Year Mean Follow-up

The American Journal of Sports Medicine ◽

10.1177/0363546519844481 ◽

2019 ◽

Vol 47 (7) ◽

pp. 1583-1590 ◽

Cited By ~ 4

Author(s):

Michella H. Hagmeijer ◽

Mario Hevesi ◽

Vishal S. Desai ◽

Thomas L. Sanders ◽

Christopher L. Camp ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Meniscal Tear ◽

Acl Injury ◽

Nonoperative Treatment ◽

Meniscal Tears ◽

Acl Injuries ◽

Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injury is one of the most frequent orthopaedic injuries and reasons for time loss in sports and carries significant implications, including posttraumatic osteoarthritis (OA). Instability associated with ACL injury has been linked to the development of secondary meniscal tears (defined as tears that develop after the initial ACL injury). To date, no study has examined secondary meniscal tears after ACL injury and their effect on OA and arthroplasty risk. Purpose: To describe the rates and natural history of secondary meniscal tears after ACL injury and to determine the effect of meniscal tear treatment on the development of OA and conversion to total knee arthroplasty (TKA). Study Design: Cohort study; Level of evidence, 3. Methods: A geographic database of >500,000 patients was reviewed to identify patients with primary ACL injuries between January 1, 1990, and December 31, 2005. Information was collected with regard to ACL injury treatment, rates/characteristics of the secondary meniscal tears, and outcomes, including development of OA and conversion to TKA. Kaplan-Meier and adjusted multivariate survival analyses were performed to test for the effect of meniscal treatment on survivorship free of OA and TKA. Results: Of 1398 primary ACL injuries, the overall rate of secondary meniscal tears was 16%. Significantly lower rates of secondary meniscal tears were noted among patients undergoing acute ACL reconstruction within 6 months (7%) as compared with patients with delayed ACL reconstruction (33%, P < .01) and nonoperative ACL management (19%, P < .01). Of the 235 secondary meniscal tears identified (196 patients), 11.5% underwent repair, 73% partial meniscectomy, and 16% were treated nonoperatively. Tears were most often medial in location (77%) and complex in morphology (56% of medial tears, 54% of lateral tears). At the time of final follow-up, no patient undergoing repair of a secondary meniscal tear (0%) underwent TKA, as opposed to 10.9% undergoing meniscectomy and 6.1% receiving nonoperative treatment ( P = .28). Conclusion: Secondary meniscal tears after ACL injury are most common among patients undergoing delayed surgical or nonoperative treatment of their primary ACL injuries. Secondary tears often present as complex tears of the medial meniscus and result in high rates of partial meniscectomy.

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Biochemical and Structural Alterations in Skeletal Muscle Following ACL Injury: A Narrative Review

International Journal of Kinesiology and Sports Science ◽

10.7575/aiac.ijkss.v.8n.1p.8 ◽

2020 ◽

Vol 8 (1) ◽

pp. 8

Author(s):

Trenton Reyes ◽

Darryn S. Willoughby

Keyword(s):

Skeletal Muscle ◽

Physical Environment ◽

Cruciate Ligament ◽

Knee Injuries ◽

Acl Injury ◽

Skeletal Muscle Atrophy ◽

Acl Injuries ◽

The Us ◽

Initial Injury ◽

Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injuries are some of the most common knee injuries that occur in the US, accounting for around 200,000 documented cases per year. Varying levels of severity can determine whether surgery is required or if physical therapy will suffice. One of the most common complications for patients is that there is significant atrophy of the impacted limb. Yet, there has not been definitive proof explaining this mechanism. Objective: The primary goal for this review was to examine some of the biochemical differences that tend to occur within and surrounding an ACL injury and the mechanisms involved in skeletal muscle atrophy and regenerative capabilities. Outcome: Multiple studies have found a connection between time spent inactive from the injury and the percentage of retained muscle after exercising again. Among decreases in muscle mass and muscle volume changes, analyses have also revealed alterations in alpha-2 macroglobulin, myostatin, heat shock protein-72, mechano GF-C24E, synovial fluid, and histochemical alterations in collagen and cartilaginous states which all seem to be primary factors in regulating effectiveness and speed of recovery from ACL injury. Conclusion: the influx of various cytokines as a response to the initial injury in relation to inflammation change the chemical and physical environment of the knee, making recovery significantly more difficult and time-consuming. Timing of injury, surgery, and re-initiation of movement after surgery are very important factors that can minimize overall damage and reduce recovery time.

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Is Anterior Cruciate Ligament Reconstruction Effective in Preventing Secondary Meniscal Tears and Osteoarthritis?

The American Journal of Sports Medicine ◽

10.1177/0363546516634325 ◽

2016 ◽

Vol 44 (7) ◽

pp. 1699-1707 ◽

Cited By ~ 60

Author(s):

Thomas L. Sanders ◽

Hilal Maradit Kremers ◽

Andrew J. Bryan ◽

Kristin M. Fruth ◽

Dirk R. Larson ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Cartilage Damage ◽

Meniscal Tear ◽

Population Based ◽

Surgical Reconstruction ◽

Meniscal Tears ◽

Level Of Evidence ◽

Initial Injury ◽

Anterior Cruciate

Background: Reconstruction of anterior cruciate ligament (ACL) tears may potentially prevent the development of secondary meniscal injuries and arthritis. Purpose/Hypothesis: The purpose of this study was to (1) evaluate the protective benefit of ACL reconstruction (ACLR) in preventing subsequent meniscal tears or arthritis, (2) determine if earlier ACLR (<1 year after injury) offers greater protective benefits than delayed reconstruction (≥1 year after injury), and (3) evaluate factors predictive of long-term sequelae after ACLR. The hypothesis was that the incidence of secondary meniscal tears, arthritis, and total knee arthroplasty (TKA) would be higher in patients treated nonoperatively after ACL tears than patients treated with surgical reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included a population-based incidence cohort of 964 patients with new-onset, isolated ACL tears between 1990 and 2000 as well as an age- and sex-matched cohort of 964 patients without ACL tears. A chart review was performed to collect information related to the initial injury, treatment, and outcomes. A total of 509 patients were treated with early ACLR, 91 with delayed ACLR, and 364 nonoperatively. All patients were retrospectively followed (range, 2 months to 25 years) to determine the development of subsequent meniscal tears, arthritis, or TKA. Results: At a mean follow-up of 13.7 years, patients treated nonoperatively after ACL tears had a significantly higher likelihood of developing a secondary meniscal tear (hazard ratio [HR], 5.4; 95% CI, 3.8-7.6), being diagnosed with arthritis (HR, 6.0; 95% CI, 4.3-8.4), and undergoing TKA (HR, 16.7; 95% CI, 5.0-55.2) compared with patients treated with ACLR. Similarly, patients treated with delayed ACLR had a higher likelihood of developing a secondary meniscal tear (HR, 3.9; 95% CI, 2.2-6.9) and being diagnosed with arthritis (HR, 6.2; 95% CI, 3.4-11.4) compared with patients treated with early ACLR. Age >21 years at the time of injury, articular cartilage damage, and medial/lateral meniscal tears were predictive of arthritis after ACLR. Conclusion: Patients treated with ACLR have a significantly lower risk of secondary meniscal tears, symptomatic arthritis, and TKA when compared with patients treated nonoperatively after ACL tears. Similarly, early ACLR significantly reduces the risk of subsequent meniscal tears and arthritis compared with delayed ACLR.

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Effects of neglected anterior cruciate ligament tears on medial and lateral meniscus

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20202568 ◽

2020 ◽

Vol 6 (4) ◽

pp. 687

Author(s):

Jeevan M. P. ◽

John T. John

Keyword(s):

Acute Phase ◽

Treatment Time ◽

Cruciate Ligament ◽

Lateral Meniscus ◽

Acl Injury ◽

Acute Injury ◽

Meniscal Injury ◽

Time Period ◽

Anterior Cruciate ◽

One Year

Background: The effects of neglected anterior cruciate ligament (ACL) tears and its impact on the medial and lateral meniscus was evaluated in this study over a one-year time period patients were grouped on the basis of their injury to treatment time. The study emphasized the importance of early treatment of ACL injury to prevent damage to the meniscal tissue and secondary osteoarthritis.Methods: Retrospective cohort study undertaken in the Department of Orthopaedics at Lourdes Hospital, Ernakulam, Kerala. Over a time period of one year starting from 2010 February. A total of 101 patients was analysed in whom Meniscal injury associated with ACL tear was noted. The patients were grouped into three based on the time from initial injury to the time of reconstruction. Acute injury (treated within 4 months of injury) sub-acute injury (treated between 4 and 8 months after injury) chronic injury (treated between 8 and 12 months after injury). The trend of meniscal injury based upon the injury to treatment time was analysed using appropriate statistical methods.Results: Immediately following ACL injury lateral meniscal injuries were more common and was found in the acute phase. Lateral meniscus tears decreased as patients passed through the acute phase into the sub-acute phase, whereas medial meniscal tears began to increase and predominated in the chronic phase. Medial meniscal injuries were common in chronic ACL tears which were often complex tears not amenable to repair.Conclusions: This study was able to demonstrate that the incidence of meniscal injury increased over time in ACL damaged knees.

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Intra-articular and meniscal pathology according to anterior cruciate ligament injury pattern: both-bundle tear or selective bundle tear

Acta Radiologica ◽

10.1177/0284185119873117 ◽

2019 ◽

Vol 61 (5) ◽

pp. 644-650

Author(s):

Jin Hee Park ◽

Hee Jin Park ◽

So Yeon Lee ◽

Hyun Pyo Hong ◽

Soo Youn Ham ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Injury ◽

Cruciate Ligament ◽

Meniscal Tear ◽

Cartilage Injury ◽

Ligament Injury ◽

Anterior Cruciate Ligament Tear ◽

Meniscal Injury ◽

Ligament Tear ◽

Anterior Cruciate

Background Articular cartilage injury and meniscal tear are usually combined with anterior cruciate ligament injury. Purpose We investigated the incidence of cartilage injury and traumatic meniscal tear according to the type of combined anterior cruciate ligament tear (both-bundle versus selective bundle tear). Material and Methods This retrospective study included 103 patients diagnosed with anterior cruciate ligament tear after knee joint magnetic resonance imaging and who underwent knee joint arthroscopy. Two radiologists evaluated articular cartilage injuries and meniscal tear independently. We used the chi-square test to analyze the association between type of anterior cruciate ligament bundle tear and presence of cartilage or meniscal injury in each reader. Results Cartilage injury presented a significantly higher prevalence in both-bundle tear than did selective bundle tear in reader 1 ( P = 0.004). In reader 2, both-bundle tear had a tendency for higher risk of cartilage injury, but this was not statistically significant ( P = 0.178). In meniscal injury, there was a statistically significant increase in the risk of associated meniscal injury in both-bundle tear versus selective bundle anterior cruciate ligament injury ( P = 0.019 and 0.021). The risk of accompanying traumatic meniscal lesion was significantly higher in both-bundle tear ( P = 0.036 and 0.018). Conclusion The incidence of accompanying meniscal injury, especially traumatic tears, is higher in both-bundle anterior cruciate ligament tear than in selective bundle tear. There was no significant difference in incidence of cartilage injury between both-bundle tear and selective bundle tear, although one of two readers showed a higher incidence in both-bundle tear.

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