scholarly journals The Safe Distance to the Popliteal Neurovascular Bundle in Pediatric Knee Arthroscopic Surgery: An Age-Based Magnetic Resonance Imaging Anatomic Study

2019 ◽  
Vol 7 (7) ◽  
pp. 232596711985502 ◽  
Author(s):  
Jonathan M. Schachne ◽  
Madison R. Heath ◽  
Yi-Meng Yen ◽  
Kevin G. Shea ◽  
Daniel W. Green ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Skeletal Maturity ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Free Edge ◽  
Neurovascular Bundle ◽  
Posterior Horn ◽  
Regression Analyses ◽  
Resonance Imaging ◽  
Safe Distance

Background: The close proximity of the popliteal neurovascular bundle to the posterior horn of the lateral meniscus puts it at risk of compromise during lateral meniscal repair. This is particularly important in smaller pediatric patients, who are commonly treated for lateral meniscal abnormalities in isolation (discoid meniscus) or concomitantly with anterior cruciate ligament reconstruction. Purpose: To quantify the distance between the posterior horn of the lateral meniscus and the popliteal neurovascular bundle along the path of meniscal repair and to investigate for associations with age, sex, height, weight, body mass index (BMI), and skeletal maturity. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 144 magnetic resonance imaging scans were evaluated in a cohort of patients aged 10 to 18 years without meniscal or ligament abnormalities. Measurements were made along a line from the anterolateral portal between the popliteal neurovascular bundle and the free edge, midpoint, and meniscocapsular junctions of the posterior horn of the lateral meniscus. In addition to descriptive statistics of these distances by age and sex, analyses of variance and linear regression analyses were performed to investigate for associations with age, sex, height, weight, BMI, and skeletal maturity. Results: Male participants had a significantly larger mean free edge distance (14.4 ± 2.5 vs 13.1 ± 2.5 mm, respectively; P = .005) and midpoint distance (9.6 ± 2.2 vs 8.9 ± 1.8 mm, respectively; P = .011) than female participants but not a significantly larger meniscocapsular distance (5.2 ± 1.6 vs 4.6 ± 1.4 mm, respectively; P = .096). Linear regression analyses revealed significant associations between these distances and age, height, weight, and BMI ( P < .001 for all). There were statistically significant pairwise differences for free edge and midpoint distances to the neurovascular bundle between patients with open and closed physes. Conclusion: The distance between the posterior horn of the lateral meniscus and the popliteal vasculature along a trajectory from the standard anterolateral arthroscopic portal increases linearly throughout development between the ages of 10 and 18 years. There were also significant associations between height, weight, BMI, and skeletal maturity and these anatomic distances. Knowing the safe distance to the popliteal vasculature will increase the safety of arthroscopic lateral meniscal repair in children, especially with all-inside devices that require setting the penetration depth for the advancement of a sharp delivery device beyond the posterior capsule.

scholarly journals A Useful MRI Classification for Symptomatic Discoid Lateral Meniscus

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Eui Yub Jung ◽  
Seongmin Jeong ◽  
Sun-Kyu Kim ◽  
Sung-Sahn Lee ◽  
Dong Jin Ryu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Discoid Lateral Meniscus ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Signal Change ◽  
Magnetic Resonance Imaging Mri ◽  
Arthroscopic Procedures ◽  
Group 1

Abstract Purpose The purpose of this study is to classify the discoid lateral meniscus (DLM) according to the signal and shape in magnetic resonance imaging (MRI), and to provide information not only in diagnosis but also in treatment. Materials and Methods We reviewed 162 cases who diagnosed with DLM by MRI and underwent arthroscopic procedures from April 2010 to March 2018. Three observers reviewed MRI findings of all cases and predicted arthroscopic tear using three MRI criteria (criterion 1,2 and 3). Among three criteria, the criterion that most accurately predicts arthroscopic tear was selected. Using this criterion, the cases of predicted tear were named group 1. In addition, group 1 was divided into three subgroups (group 1a, 1b and 1c) by deformation or displacement on MRI and arthroscopic type of tear and procedures were analyzed according to these subgroups. Results The intra-meniscal signal change itself (criterion 3) on MRI showed the highest agreement with the arthroscopic tear. No meniscal deformation and displacement on MRI (group 1a) showed no specific type of tear and more cases of meniscal saucerization. The meniscal deformation on MRI (group 1b) showed more simple horizontal tears and more cases of meniscal saucerization. The meniscal displacement on MRI (group 1c) showed more peripheral tears and more cases of meniscal repair and subtotal meniscectomy. Comparing arthroscopic type of tear and type of arthroscopic procedure between three subgroups, there were significant differences in three groups (P < .05). Conclusions Intra-meniscal signal change itself on MRI is the most accurate finding to predict arthroscopic tear in symptomatic DLM. In addition, subgroup analysis by deformation or displacement on MRI is helpful to predict the type of arthroscopic tear and procedures.

Different Regional Healing Rates with the Outside-In Technique for Meniscal Repair

1998 ◽  
Vol 26 (3) ◽  
pp. 446-452 ◽  
Author(s):  
Michiel F. van Trommel ◽  
Peter T. Simonian ◽  
Hollis G. Potter ◽  
Thomas L. Wickiewicz
Keyword(s):  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Current Method ◽  
Complete Healing ◽  
Posterior Horn ◽  
Resonance Imaging ◽  
Anterior Portion ◽  
Meniscus Tears

Fifty-one patients with meniscal repair using the outside-in technique were reassessed with second-look arthroscopic procedures (N 15), arthrographic examination (N 41), magnetic resonance imaging (N 36), or a combination of these techniques. Forty-one medial and 10 lateral menisci were repaired. The average clinical follow-up was 15 months (range, 3 to 80). Forty-five of 51 patients had tears that were located in or extended into the posterior horn of the medial or lateral meniscus. Complete healing occurred in 23 menisci (45%), partial healing was observed in 16 (15 medial, 1 lateral) (32%), and no healing occurred in 12 (24%). Remarkably, in all 15 patients who had tears extending from the posterior to the middle third of the medial meniscus that were partially healed, it was always the posterior third that had not fully healed. This finding is statistically significant. In addition, the middle third of these menisci had not fully healed in five patients. No healing occurred in the two patients with tears in the posterior third of the medial meniscus. Poor healing with the outside-in technique was observed in patients with tears into the posterior horn of the medial meniscus. For tears in the middle and anterior portion of the medial meniscus, as well as all lateral meniscus tears, the outside-in technique is our current method of choice.

Prediction of reparability of isolated semilunar lateral meniscus tears by magnetic resonance imaging

2002 ◽  
Vol 10 (4) ◽  
pp. 213-217 ◽  
Author(s):  
Yoshiki Shiozaki ◽  
Shuji Horibe ◽  
Tomoki Mitsuoka ◽  
Norimasa Nakamura ◽  
Yukiyoshi Toritsuka ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lateral Meniscus ◽  
Resonance Imaging ◽  
Meniscus Tears

scholarly journals Prevalence of Asymptomatic Intra-articular Changes of the Knee in Adult Professional Soccer Players

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711988537 ◽  
Author(s):  
Eduard Nikolayevich Bezuglov ◽  
Anastasiya Vladimirovna Lyubushkina ◽  
Vladimir Yurevich Khaitin ◽  
Alisa Viktorovna Tokareva ◽  
Evgeny Nikolayevich Goncharov ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Femoral Condyle ◽  
Lateral Meniscus ◽  
Soccer Players ◽  
Knee Joints ◽  
Resonance Imaging ◽  
Cartilage Lesions ◽  
Professional Soccer ◽  
Meniscal Lesions

Background: Currently, there are few data on the association between participation in soccer and the condition of the knee joints in adult professional players. Hypothesis: A high percentage of professional soccer players will have asymptomatic intra-articular changes of the knee. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The condition of the intra-articular structures (osteophytes, cartilage, and menisci) in 94 knee joints of 47 adult professional soccer players (mean ± SD age, 25.7 ± 4.6 years; body mass index, 22.8 ± 1.4 kg/m2) was analyzed. A 1.5-T magnetic resonance imaging scanner was used to perform the imaging, and the anonymized data were analyzed by 2 experienced radiologists. Results: Cartilage of both knee joints was affected in 97.9% of soccer players. Meniscal lesions were detected in 97.8% of joints, affecting both joints in 93.6% of athletes. Grade 2 cartilage lesions were the most prevalent (36%-60% depending on the lesion site), and grade 4 lesions were detected in 12.7% of joints. The medial femoral condyle and medial tibial plateau were most frequently affected by cartilage lesions (85.1%). Among meniscal lesions, grade 2 lesions were the most prevalent, being detected in 71% of the cases. Grade 3 lesions were detected in 13.8% of the joints. The posterior horn of the lateral meniscus was the most common site of meniscal lesions (affected in 95.7% of the joints). Osteophytes were detected in 4.2% of joints. Conclusion: The prevalence of asymptomatic cartilage and meniscal lesions in the knees of adult professional soccer players is extremely high and is not associated with the reduction of sports involvement. This research should promote the correct interpretation of magnetic resonance imaging data obtained from soccer players with acute trauma and the reduction of the number of unwarranted surgical procedures.

Assessment of Meniscal Healing Status by Magnetic Resonance Imaging T2 Mapping After Meniscal Repair

2020 ◽  
Vol 48 (4) ◽  
pp. 853-860
Author(s):  
Shinya Yamasaki ◽  
Yusuke Hashimoto ◽  
Yohei Nishida ◽  
Takanori Teraoka ◽  
Shozaburo Terai ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
T2 Mapping ◽  
Meniscal Tear ◽  
Meniscal Repair ◽  
T2 Relaxation Time ◽  
Resonance Imaging ◽  
T2 Relaxation ◽  
Conventional Mri ◽  
Meniscal Healing ◽  
The Mean

Background: Although the sensitivity and specificity of magnetic resonance imaging (MRI) for the diagnosis of primary meniscal tears are high, these values are lower for the assessment of healing status of repaired menisci. Purpose: To compare the accuracy of MRI T2 mapping and conventional MRI in assessing meniscal healing after repair. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Patients who underwent meniscal repair with concurrent anterior cruciate ligament reconstruction between 2012 and 2016 and had a follow-up second-look arthroscopy were enrolled. The patients were divided into healed and incompletely/not healed groups based on the second-look arthroscopy findings. For the repaired menisci, the following were compared between the groups, (1) Stoller and Crues classification on conventional MRI with a proton density-weighted fat-saturated sequence and (2) the remaining colored meniscal tear line on T2 mapping coincident with the high signal line showing the primary tear on conventional MRI were compared. The change of T2 relaxation time (ΔT2) of the colored meniscal tear line pre- to postoperatively was compared between the groups. The mean T2 relaxation time of the whole area of the postoperative meniscus at each slice was also compared with that of control menisci to assess the whole quality of the repaired meniscus. Results: A total of 26 menisci from 24 knees were assessed (16 healed menisci, 10 incompletely/not healed menisci). According to the Crues classification on conventional MRI, 8 of 16 healed menisci and 3 of 10 incompletely/not healed menisci improved from grade 3 to 2, with there being no significant difference between the groups ( P = .43). However, the colored meniscal tear line remained in only 3 of the 16 healed menisci as compared with 9 of the 10 incompletely/not healed menisci, and the presence of this colored line allowed differentiation between healed menisci and incompletely/not healed menisci (sensitivity, 81.3%; specificity, 90.0%; odds ratio, 39.0; P = .001). The mean (SD) ΔT2 was −31.1 ± 3.2 and −19.9 ± 4.4 ms in the healed and incompletely/not healed groups, respectively ( P < .001). Receiver operating characteristic curve analysis showed a cutoff ΔT2 value of −22.3 ms for separation of meniscal healing ( P < .001). The T2 relaxation times of the whole area of the repaired menisci were 31.7 ± 3.4 and 32.8 ± 3.8 ms in the healed and incompletely/unhealed groups, respectively ( P = .69), with these values being significantly longer than the 26.9 ± 2.2 ms in the controls ( P < .001). Conclusion: MRI T2 mapping allowed the differentiation of healing status after meniscal repair, with high sensitivity and specificity as compared with conventional MRI.

scholarly journals Dynamics of the meniscus underweight-loading conditions: an investigation using upright magnetic resonance imaging

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0045
Author(s):  
Junsuke Nakase ◽  
Kengo Shimozaki ◽  
Rikuto Yoshimizu ◽  
Hiroyuki Tsuchiya ◽  
Kazuki Asai
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Supine Position ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Loading Conditions ◽  
Resonance Imaging ◽  
Significant Difference ◽  
Posterior Shift ◽  
Weight Loading

Objectives: Meniscal morphology underweight-loading conditions remains unknown, because weight loading is rarely performed during magnetic resonance imaging (MRI). We focused on the weight-loading condition and developed an upright MRI. This study aimed to investigate the shift of the medial and lateral meniscus in healthy adults under both fully weight loaded and unloaded conditions, using both supine and upright MRI. Methods: Eighteen volunteers (13 men and 5 women) without previous knee complaints underwent an MRI of the right knee. The mean age of the subjects was 21.8±3.1 years. The examination was performed in three positions: supine, double-leg upright (DLU), and single-leg upright (SLU). The knees were fully extended in each position. For both the supine and upright examinations, we used a special MRI apparatus (Gravity MRI, Hitachi, Japan) that is capable of imaging in any position with a static magnetic field strength of 0.4 T (Figure). T1-weighted images were obtained in both coronal and sagittal planes with a slice thickness of 2 mm. The medial or lateral, anterior and posterior shifts of both the medial and lateral meniscus were measured, against the tibial wedge. The medial and lateral meniscal shift rates were measured as assessment items under each condition. The shift rate was defined as the proportion of the measured meniscal shift compared to the overall width of the medial and lateral meniscus. The MRI reference section on the sagittal plane was the midpoint of the medial or lateral femoral condyle. On the coronal plane, the reference point was the midpoint of the medial and lateral tibial condyle. The measurement items were compared in all three imaging positions using analysis of variance and multiple comparison tests, with statistical significance set at P < 0.05. Results: We show the results from the analysis of the dynamics of the medial and lateral meniscus in Table. The difference among the three conditions for the medial shift rate of the medial meniscus was significant. The medial shift rate was significantly greater in the DLU and SLU positions than in the supine position (supine: 7.3±5.8% vs. DLU: 20.0±8.8 % (P<0.01), supine vs. SLU: 21.5±7.6% (P<0.01), DLU vs. SLU (P=0.7)). No significant differences were observed for the anterior and posterior shift rates of the medial meniscus (anterior: P=0.6, posterior: P=0.4). In the lateral meniscus, the lateral shift rate was significantly greater in the SLU position than in the supine position, but no significant difference was observed in the DLU position (supine: -1.2±11.8% vs. DLU: 2.7±11.1 % (P=0.2), supine vs. SLU: 4.5±10.8% (P=0.04), DLU vs. SLU: P=0.7). Both anterior and posterior shift rates in the lateral meniscus were significantly greater in DLU and SLU positions than in the supine position (anterior/ supine: -20.6±14.3% vs. DLU: -14.7±12.2% (P<0.01), supine vs. SLU: -8.9±14.9% (P<0.01), DLU vs. SLU: P=0.3, posterior/ supine: -78.0±19.6% vs. DLU: -63.7±18.7 % (P<0.01), supine vs. SLU: -57.8±19.2% (P<0.01), DLU vs. SLU: P=0.4). Conclusions: Under upright weight-loading conditions, the medial meniscus showed only medial shift, whilst the lateral meniscus was seen to shift in lateral, anterior, and posterior directions. No significant difference was observed between the DLU and SLU shift rates in both the medial and lateral meniscus in healthy adults. We believe that this result will be useful when considering loading and rehabilitation following meniscal repair. [Table: see text]

scholarly journals DEFINING A SAFE ZONE FOR ALL INSIDE LATERAL MENISCUS REPAIRS IN PEDIATRIC PATIENTS: A MAGNETIC RESONANCE IMAGING STUDY

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0017
Author(s):  
Jennifer Beck ◽  
Kendall Shifflett ◽  
Danielle Greg ◽  
Edward Ebramzadeh ◽  
Richard E. Bowen
Keyword(s):  
Pediatric Patients ◽  
Age Groups ◽  
Lateral Meniscus ◽  
Safe Zone ◽  
Neurovascular Bundle ◽  
Posterior Horn ◽  
Popliteus Tendon ◽  
Anterior Edge ◽  
Group I ◽  
Significant Difference

Purpose All-inside posterior horn lateral meniscal (PHLM) repair puts the popliteal neurovascular bundle (PVNB) at risk of injury by meniscal repair devices. The purpose of this study was to establish a safe zone of all-inside meniscal fixation in pediatric patients using MRI measurements between the popliteus tendon (PT) and popliteal neurovascular bundle (PNVB). We hypothesize that males and older age groups will have a larger distance between PT and PNVB. Methods Axial MRIs of 250 pediatric (5-16 yrs.) patients were retrospectively reviewed. Patients were grouped by age: group I (5-7yrs.): 61; II (8-10yrs.): 59; III (11-13yrs.): 60; IV (14-16yrs.): 70. At the level of the lateral meniscus, two lines starting at the lateral patella tendon border ending at the medial edge of the PT (D1) and the lateral edge of the PNVB (D2) were made on an axial knee MRI. D3 connected D1 to D2 at the meniscocapsular junction of the PHLM. D4 was derived geometrically, parallel and 8 mm anterior to D3 simulating the anterior edge of the PHLM. Results Analysis showed significant correlation between age and sex for D3 (p<0.0001). For D3, there were significant differences among all age groups, except between groups III and IV. Average (STD) D3 for age groups was: 14.1mm(3.1), 15.8(2.5), 17.0(3.3), 17.2(3.1). For D4, the average (STD) was: 11.9 mm(2.9); 13.9(2.5); 15.4(3.0); 15.2(2.9). There was significant difference in D3 and D4 in males versus females (17.6 vs 15.7 mm; p <0.001; 14.9 vs 13.2; p <0.001), particularly in III and IV (17.0 vs 13.8 and 16.8 vs 13.9). Conclusions This study provides normative data of the distance between popliteal neurovascular bundle and popliteus tendon at the meniscocapsular junction (D3) and anterior edge of the posterior horn lateral meniscus (D4) with the knee in full extension. Combined with previous studies showing the addition of knee flexion increases the distance between the meniscus and the neurovascular bundle, surgeons can use this data to improve safety of posterior horn lateral meniscus repair in pediatric patients.

Radiographic Methods Are as Accurate as Magnetic Resonance Imaging for Graft Sizing Before Lateral Meniscal Transplantation

2020 ◽  
Vol 48 (14) ◽  
pp. 3534-3540
Author(s):  
Luiz Felipe Ambra ◽  
Camila Cohen Kaleka ◽  
Pedro Debieux ◽  
Julio Cesar Almeida ◽  
Nehal Shah ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lateral Meniscus ◽  
Absolute Difference ◽  
Resonance Imaging ◽  
Radiographic Method ◽  
Meniscal Transplantation ◽  
Meniscal Allograft ◽  
Anatomic Dissection ◽  
Fresh Frozen

Background: Accurate allograft matching is deemed critical for meniscal transplantation; thus, precise measurements are essential to correctly calculate meniscal size. Several methods for meniscal sizing have been described, but there remains a discussion on which is the most accurate for the lateral meniscus. Purpose: To compare the accuracy of radiographic, anthropometric, and magnetic resonance imaging (MRI) methods of determining width and length of the lateral meniscus with actual dimensions after anatomic dissection. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen human cadaveric knees without any evidence of meniscal or ligamentous injury were primarily imaged using radiography and MRI and subsequently underwent dissection to assess the anatomic size of each meniscus. Four methods were used to predict the size of the lateral menisci: anthropometric, radiographic (Pollard and Yoon), and MRI. Absolute differences in length and width between actual and predicted sizes were determined. Results: The anatomic lateral meniscal width and length were 33.01 ± 4.25 mm (mean ± SD; range, 24.84-40.18 mm) and 31.41 ± 5.06 mm (range, 25.2-40.05 mm), respectively. Regarding width, the anthropometric method demonstrated an absolute difference from anatomic measurement significantly greater when compared with the Pollard technique and MRI ( P = .002). Regarding length, the Pollard method presented an absolute difference significantly greater than all other techniques ( P = .003). In terms of the ability to measure width and length, MRI accurately predicted meniscal size within 10% of the anatomic size in 65% of measurements, the Yoon method in 54%, and the Pollard method in 20% ( P = .01). Radiographs tended to overestimate the true size of the lateral meniscus, while the anthropometric technique overestimated width in all specimens. Conclusion: This study demonstrated that MRI and the Yoon radiographic method are comparable in terms of accuracy for graft sizing before lateral meniscal transplantation. While MRI is useful, a contralateral MRI is required, which makes the Yoon radiographic method recommended given the ease and cost advantage. The original Pollard technique and the anthropometric method are not recommended. Clinical Relevance: Over- and undersizing of meniscal transplants has been implicated in graft failure. Therefore, increasing the reliability of preoperative meniscal measurements is deemed important for the success of meniscal allograft transplantation.

Posterolateral complex knee injuries: magnetic resonance imaging with surgical correlation

2005 ◽  
Vol 46 (3) ◽  
pp. 297-305 ◽  
Author(s):  
D. J. Theodorou ◽  
S. J. Theodorou ◽  
D. C. Fithian ◽  
L. Paxton ◽  
D. H. Garelick ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Medial Meniscus ◽  
Biceps Tendon ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Joint Effusion ◽  
Popliteus Tendon ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Posterolateral Complex

Purpose: To describe the magnetic resonance imaging (MRI) findings of injuries of the posterolateral aspect of the knee and to evaluate the diagnostic capabilities of MRI in the assessment of these injuries. Material and Methods: The MRI studies of 14 patients (mean age 33 years) with trauma to the posterolateral aspect of the knee were retrospectively reviewed, and the imaging findings were correlated with those of surgery. Results: In all patients, MRI showed an intact iliotibial (ITB) band. MRI showed injury to the biceps tendon in 11 (79%), the gastrocnemius tendon in 1 (7%), the popliteus tendon in 5 (36%), and the lateral collateral ligament (LCL) in 14 (100%) patients. Tear of the anterior cruciate ligament (ACL) was seen in 11 (79%) patients and tear of the posterior cruciate ligament (PCL) in 4 (29%) patients. With routine MRI, visualization of the popliteofibular or fabellofibular ligaments was incomplete. On MRI, the lateral meniscus and the medial meniscus were torn with equal frequency ( n = 4; 29%). Osteochondral defects were seen in 5 (36%) cases and joint effusion in all 14 (100%) cases on MRI. Using surgical findings as the standard for diagnosis, MRI proved 86% accurate in the detection of injury to the ITB band, the biceps tendon (93%), the gastrocnemius tendon (100%), the popliteus tendon (86%), the LCL (100%), the ACL (79%), the PCL (86%), the lateral meniscus (90%), the medial meniscus (82%), and the osteochondral structures (79%). Surgical correlation confirmed the MRI findings of joint effusion in all cases. Conclusion: MRI is well suited for demonstrating the presence and extent of injuries of the major structures of the posterolateral complex of the knee, allowing characterization of the severity of injury.

Sign in / Sign up

Export Citation Format

Share Document