Incidence of Associated Knee Lesions with Torn Anterior Cruciate Ligament: Retrospective Cohort Assessment

1998 ◽  
Vol 7 (1) ◽  
pp. 1-8 ◽  
Author(s):  
George A. Arangio ◽  
Edward W. Cohen

The records of 141 consecutive patients with confirmed complete anterior cruciate ligament injuries were reviewed retrospectively. One hundred and sixty-two associated injuries were divided into 25 injury complexes. Isolated injuries to the anterior cruciate ligament occurred in 40 cases (28.4%). Injuries of the medial meniscus occurred in 62 cases (38.2%), while injuries of the lateral meniscus occurred in 37 cases (22.8%). Injuries to the medial collateral ligament complex occurred in 42 cases (25.9%). Injuries to the lateral collateral ligament, posterior deep popliteus-arcuate ligament complex, and posterior cruciate ligament were found to be positively correlated (rho = .81, p = .001, and rho = .77, p = .001, N = 141, respectively). Injuries to the medial collateral ligament and the posterior oblique ligament were likewise positively correlated (rho = .45, p = .001, N = 141).

2019 ◽  
Author(s):  
Stephanie G. Cone ◽  
Hope E. Piercy ◽  
Emily P. Lambeth ◽  
Hongyu Ru ◽  
Jorge A. Piedrahita ◽  
...  

AbstractPrior studies have analyzed growth of musculoskeletal tissues between species or across body segments; however, little research has assessed the differences in similar tissues within a single joint. Here we studied changes in the length and cross-sectional area of four ligaments and tendons, (anterior cruciate ligament, patellar tendon, medial collateral ligament, lateral collateral ligament) in the tibiofemoral joint of female Yorkshire pigs through high-field magnetic resonance imaging throughout growth. Tissue lengths increased by 4-to 5-fold from birth to late adolescence across the tissues while tissue cross-sectional area increased by 10-20-fold. The anterior cruciate ligament and lateral collateral ligament showed allometric growth favoring change in length over change in cross-sectional area while the patellar tendon and medial collateral ligament grow in an isometric manner. Additionally, changes in the length and cross-sectional area of the anterior cruciate ligament did not increase as much as in the other ligaments and tendon of interest. Overall, these findings suggest that musculoskeletal soft tissue morphometry can vary within tissues of similar structure and within a single joint during post-natal growth.


2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
John A. Schlechter ◽  
Tanner Harrah ◽  
Bryn Gornick ◽  
Benjamin Sherman

Introduction: With participation in youth sports anterior cruciate ligament (ACL) injuries are a common occurrence. Nearly 70% of ACL tears in children and adolescents have an associated meniscus tear. Percutaneous medial collateral ligament (MCL) relaxation has been described as utilitarian in accessing the medial meniscus for diagnostic assessment and treatment in the adult population to increase medial compartment working space in arthroscopic surgery. The technique has not been evaluated in the pediatric population. The purpose of this study was to compare the outcomes of children and adolescents that underwent anterior cruciate ligament reconstruction (ACLR) with and without percutaneous relaxation of the medial collateral ligament (MCL) for meniscal tear management. Methods: A retrospective review was performed of patients aged 8 to 19 years old that had undergone knee arthroscopy for an (ACLR) with meniscus pathology. Those that underwent MCL relaxation were grouped together and compared to a matched cohort that did not have MCL relaxation performed. Preoperative, operative and postoperative data was analyzed. The primary measurement was obtained using a validated patient reported outcome score (Pedi-IKDC), secondary outcome measures were defined as superficial or deep infection, saphenous nerve dysesthesias, ACL graft failure and return to the operating room. Statistical analysis of the two cohorts was performed. Results: Fifty-four patients were included in the study (27 in each group) with average age 15 years (range 10-19). Average follow-up for the MCL relaxation group was 22.4 months versus 58 months for the non-MCL relaxation group. The average Pedi-IKDC score was 93.3 for the MCL relaxation group and 91.4 for the non-MCL relaxation group (p=0.34). There was no difference in patient demographics, return to the operating room (p=0.49), saphenous nerve dysesthesia (p=0.49), superficial or deep infection (p=0.32). Conclusion: ACL reconstruction in children and adolescents with MCL relaxation for the management of medial meniscal tears appears to be a safe option. Equivocal patient reported outcome scores as compared to the control group were found with no increase in post-operative complications. In children with ACL tears, appropriate diagnosis and management of medial meniscal pathology is important to maintain secondary restraint to anterior tibial translation and prevent premature graft failure. Pediatric knees can have tight medial compartments, making access difficult, potentially leading to poor visualization and iatrogenic chondral damage. Percutaneous medial collateral ligament (MCL) relaxation has been described in the adult population to increase medial compartment working space without long term sequela. We report similar findings in an all pediatric cohort.


2022 ◽  
Vol 8 (1) ◽  
pp. 12-23
Author(s):  
Poonam Ohri ◽  
Shreeji Goya ◽  
Niveditha C ◽  
Manasi Kohli

Background: Knee is one of the major joints involved in kinesis. With increasing involvement in sports related activities especially in young people, Trauma related knee pathologies have increased. An accurate diagnosis regarding the type and extent of injuries is essential for early operative as well as non-operative treatment. Methods:This prospective study included total of 82 cases. The patients were referred to the department of Radiodiagnosis from indoor and outdoor departments of Guru Nanak Dev Hospital, Amritsar with suspicion of internal derangement of the knee and with history of knee trauma.Results:The most common age group involved was young males between 15-34 years. In all age groups most of the patients were males. Most common ligament to be injured was Anterior Cruciate Ligament (ACL). Partial tears were more common than complete tears. Posterior Cruciate Ligament (PCL) tears were less common. Medial Collateral Ligament (MCL) tears outnumbered Lateral Collateral Ligament (LCL) tears and grade 2 tears were more common in both. Among the meniscal injuries Medial Meniscus (MM) tears were more common than LM and grade 3 signal was more common in both. Most of the patellar retinaculum injuries were associated with Anterior Cruciate Ligament ACL tears.Conclusions:Post-traumatic pre-arthroscopic MR imaging evaluation has proved to be cost-effective. MRI is an accurate imaging modality complementing the clinical evaluation and providing a global intra-articular and extra-articular assessment of the knee.


2003 ◽  
Vol 31 (2) ◽  
pp. 261-267 ◽  
Author(s):  
Norimasa Nakamura ◽  
Shuji Horibe ◽  
Yukiyoshi Toritsuka ◽  
Tomoki Mitsuoka ◽  
Hideki Yoshikawa ◽  
...  

Background: The appropriate management of acute grade III medial collateral ligament injury when it is combined with a torn anterior cruciate ligament has not been determined. Hypothesis: Magnetic resonance imaging grading of grade III medial collateral ligament injury in patients who also have anterior cruciate ligament injury correlates with the outcome of their nonoperative treatment. Study Design: Prospective cohort study. Methods: Seventeen patients were first treated nonoperatively with bracing. Eleven patients with restored valgus stability received anterior cruciate ligament reconstruction only, and six with residual valgus laxity also received medial collateral ligament surgery. Results: Magnetic resonance imaging depicted complete disruption of the superficial layer of the medial collateral ligament in all 17 patients and disruption of the deep layer in 14. Restoration of valgus stability was significantly correlated with the location of superficial fiber damage. Damage was evident over the whole length of the superficial layer in five patients, and all five patients had residual valgus laxity despite bracing. Both groups had good-to-excellent results 5 years later. Conclusions: Location of injury in the superficial layer may be useful in predicting the outcome of nonoperative treatment for acute grade III medial collateral ligament lesions combined with anterior cruciate ligament injury.


2020 ◽  
Vol 48 (9) ◽  
pp. 2213-2220
Author(s):  
Lachlan M. Batty ◽  
Jerome Murgier ◽  
Julian A. Feller ◽  
Richard O’Sullivan ◽  
Kate E. Webster ◽  
...  

Background: Recent biomechanical studies have demonstrated that the Kaplan fibers (KFs) of the iliotibial band play a role in the control of anterolateral rotation of the knee. However, controversy exists regarding whether the KFs are injured in conjunction with anterior cruciate ligament (ACL) injury. Purpose: To establish the prevalence of radiological injury to the KFs in the ACL-injured knee; to evaluate the effect of the time interval between injury and magnetic resonance imaging (MRI) on diagnosis of KF injury; and to assess for any association between KF injury and other qualitative radiological findings. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Preoperative MRI scans were reviewed for 161 patients with ACL injury. Specific diagnostic criteria were developed and applied to identify KF injury. Chi-square testing was performed to look for associations among KF injury, the time from injury to MRI, and associated radiological knee injuries. Results: Radiological evidence of KF injury was identified in 30 (18.6%) patients. The diagnosis of KF injury was higher in patients who had MRI scans performed within 90 days of injury as compared with ≥90 days after injury (23.7 vs 6.4%; P = .010). Patients with an MRI diagnosis of KF injury had significantly higher rates of lateral meniscal injury (40% vs 18%; P = .007), posteromedial tibial bone marrow edema (73% vs 44%; P = .003), and injury to the lateral collateral ligament (13% vs 3%; P = .019) or medial collateral ligament (23% vs 8%; P = .019). Conclusion: The prevalence of injury to the KF in patients with ACL injury as diagnosed by MRI was relatively low (18.6% of patients). However, the time interval from injury to MRI was relevant to diagnosis, with significantly higher rates of injury identification in patients with early (within 90 days) versus delayed (≥90 days) MRI. KF injury was associated with higher rates of injury to the lateral meniscal and collateral ligaments, as well as posteromedial tibial bone bruising.


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