scholarly journals Concomitant injuries of anterior cruciate ligament and meniscus

2016 ◽  
Vol 69 (7-8) ◽  
pp. 217-223 ◽  
Author(s):  
Vladimir Ristic ◽  
Mirsad Maljanovic ◽  
Ivan Mihajlov ◽  
Vukadin Milankov ◽  
Vladimir Harhaji
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Meniscal Injury ◽  
Concomitant Injuries ◽  
Male Patients ◽  
Anterior Cruciate ◽  
Contact Mechanism ◽  
Bucket Handle

Introduction. The aim of this study was to determine the correlation between meniscal injuries with injuries of the anterior cruciate ligament, as well as risk factors for those associated injuries. Material and Methods. This study included 496 operated patients. Almost half of patients with meniscal injury were between the ages of 21 and 30 years. Results. Meniscal injuries were diagnosed in 187 patients (38%). These patients were significantly older than the patients without meniscal injury. Meniscal injuries were significantly more frequent in patients who played sports recreationally than in professional athletes. The patients with meniscal injury underwent surgery almost four months later than the patients with preserved menisci. Meniscal injuries occurred significantly more frequently by non - contact mechanism, as a result of landing and sudden changes of direction and rhythm of running. Conclusion. Male patients hurt the medial meniscus more often, ?bucket handle? type of lesion being much more frequent than on the lateral meniscus. The increase of body mass index is exactly proportional to the increase in the incidence of meniscal injuries.

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

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.

scholarly journals Evaluation of functional outcome of bucket handle medial meniscus repair along with anterior cruciate ligament reconstruction

2020 ◽  
Vol 6 (3) ◽  
pp. 499
Author(s):  
Akshay Jain ◽  
Adhir Jain ◽  
Manjeet Singh ◽  
Prateek Pathak
Keyword(s):  
Anterior Cruciate Ligament ◽  
Functional Outcomes ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Meniscal Repair ◽  
Meniscus Repair ◽  
Meniscus Tears ◽  
Anterior Cruciate ◽  
Bucket Handle

<p class="abstract"><strong>Background:</strong> Bucket-handle meniscus tears (BHMT) are often displaced and unstable and comprise nearly 10% of all meniscus tears and commonly affect the young male population. Displacement of the free segment can lead to significant pain and disability, necessitating reduction and surgical treatment. The aim of present prospective longitudinal cohort study was to evaluate the functional outcomes of bucket handle medial meniscus repair along with anterior cruciate ligament (ACL) reconstruction at 2 years follow up.</p><p class="abstract"><strong>Methods:</strong> Between January 2017 to December 2018, 30 patients who underwent ACL reconstruction along with bucket handle medial meniscus repair were included in the study. Meniscus repair was done using the all inside, outside in, inside out or hybrid techniques. All patients were evaluated clinically at pre op and at 2 year follow up using knee injury and osteoarthritis outcome score and compared. Meniscal healing was assessed clinically using Barrett’s criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> The study comprised 30 patients with a mean age of 27.47 years (range from 13 to 49 years) with 66.67% males. According to clinical examination and Barrett criteria’s the clinical failure rate was 6.67% (2 out of 30 patients) who underwent partial menisectomy later. We also compared functional outcomes of sedentary and active peoplesand also between meniscal repair of less than 3 cm and more than 3 cm’s. There was no statistically significant difference in the functional outcomes in both the groups; however range of motion was significantly higher in tear length 3 cm or less compared to more than 3 cm.</p><p class="abstract"><strong>Conclusions:</strong> Meniscal repair should be aggressively considered in young pa­tients to enhance functional recovery and durability of the knee joint, if the meniscus is reparable.</p>

scholarly journals Clinical, Magnetic Resonance Imaging, and Arthroscopic Correlation in Anterior Cruciate Ligament and Meniscal Injuries of the Knee

2018 ◽  
Vol 24 (1) ◽  
pp. 52-56
Author(s):  
Patel Ishani ◽  
Chandru Vijay ◽  
Nekkanti Supreeth ◽  
Renukarya Ravishankar ◽  
Reddy Vishnu Vardhan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Resonance Imaging ◽  
Clinical Magnetic Resonance Imaging ◽  
Anterior Cruciate

Background The aim of this study is to compare and correlate the clinical, magnetic resonance imaging (MRI), and arthroscopy findings in anterior cruciate ligament (ACL) and meniscal injuries of the knee. Methods This was a prospective study of 30 cases of ACL and meniscal injuries of the knee admitted between September 2014 and May 2016, who underwent clinical examination, MRI, and arthroscopy of the knee. Results In our study of 30 cases, there were 26 male and four female patients with age ranging from 18 years to 60 years, with most patients in between 21 years and 30 years. Clinical examination had sensitivity of 90.91%, specificity of 100%, and accuracy of 93.33% for ACL, sensitivity of 83.33%, specificity of 77.78%, and accuracy of 80% for medial meniscus, and sensitivity of 75%, specificity of 77.27%, and accuracy of 76.67% for lateral meniscus. MRI had sensitivity of 95.45%, specificity of 87.5%, and accuracy of 93.33% for ACL, sensitivity of 91.67%, specificity of 55.56%, and accuracy of 70% for medial meniscus, and sensitivity of 62.5%, specificity of 72.73%, and accuracy of 70% for lateral meniscus. Conclusion In conclusion, the present study supports that clinical diagnosis is of primary necessity, as the positive predictive value is high for all the lesions. MRI is an additional diagnosing tool for ligament and meniscal injuries of the knee. Routine use of MRI to confirm the diagnosis is not indicated, as the positive predictive value is low, but can be used to exclude pathology, as the negative predictive value is high for all the lesions.

Comparison of Cases with Anterior Cruciate Ligament Reconstruction Accompanied by Simultaneous Medial Meniscus Bucket Handle Tear Repair and Isolated Medial Meniscus Bucket Handle Tear Repair

2021 ◽  
Author(s):  
Yavuz Akalın ◽  
Özgür Avcı ◽  
Savaş İ. İnce ◽  
Nazan Çevik ◽  
İsmail G. Şahin ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Success Rate ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Meniscus Tears ◽  
The Mean ◽  
Anterior Cruciate ◽  
Bucket Handle Tear ◽  
Bucket Handle

AbstractThe aim of this study was to evaluate the success of the all-inside repair technique for medial bucket-handle meniscus tear (BHMT) and the factors affecting healing. A total of 36 patients with BHMT who were operated between 2012 and 2018 and completed final follow-up examinations were included in the study. Functional evaluation was made with the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score. Healing was evaluated on magnetic resonance imaging (MRI) slices. The patients were evaluated with respect to the effect on healing of factors such as demographic data, body mass index (BMI), smoking status, anterior cruciate ligament tear reconstruction (ACLTR) applied at the same time as BHMT repair, and the tear being chronic or acute. The mean age of the patients was 28.6 ± 8.6 years (range,18–46 years), the mean follow-up period was 25.8 ± 13.9 months (range, 13–59 months), and BMI was mean 25.6 ± 3.5 kg/m2 (range, 20.1–30.5 kg/m2). The meniscus tears were acute in 16 (44.4%) patients and chronic in 20 (55.6%). ACLTR was applied together with BHMT repair in 25 patients. The hybrid technique, as the outside-in technique in addition to the all-inside technique, was applied to 12 (33.3%) patients, where there was seen to be extension to the anterior horn. The failure rate was determined as 27.8% according to the postoperative MRI evaluation and the Barrett criteria. No positive or negative statistically significant effect on healing was determined of chronic BHMT or of simultaneous application of ACLTR (p = 1.00 and 0.457, respectively). Cigarette smoking and high BMI were determined to have a statistically significant negative effect on healing (p = 0.026 and 0.007, respectively). In conclusion, it can be seen that the success of the all-inside technique for BHMT remains controversial. Due to the features of the application, it can be used in meniscus tears of the posterior horn only. In the current study, with the success rate of 72.2% of the all-inside technique in meniscus body tears, it was seen that a high success rate could not be achieved.

scholarly journals Accuracy of magnetic resonance imaging for meniscal body tear in anterior cruciate ligament-deficient knees compared to anterior cruciate ligament-intact knee

2021 ◽  
Vol 2 ◽  
pp. 18-25
Author(s):  
Amit Joshi ◽  
Nagmani Singh ◽  
Bibek Basukala ◽  
Rohit Bista ◽  
Navin Tripathi ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Meniscus Tear ◽  
Resonance Imaging ◽  
Anterior Cruciate ◽  
Acl Deficient ◽  
Deficient Knee ◽  
Intact Knee

Objectives: This prospective case–control study was conducted with primary aim to compare the value of magnetic resonance imaging (MRI) in terms of accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for the detection of meniscal tear in anterior cruciate ligament (ACL)-deficient and ACL-intact groups. The secondary aim was to identify if the sensitivity and accuracy differ if the MRI is older than 3 months from the time of surgery. Materials and Methods: There were 255 patients enrolled into this study out of which 207 fulfilled the inclusion criteria. Among 207, 138 underwent surgery within 1 month of MRI, 30 had 1–3 months delay, and 39 cases underwent surgery more than 3 months after their MRI. Among 167 patients who underwent surgery within 3 months of MRI, 97 had ACL tear and 71 had intact ACL. Results: The overall sensitivity for lateral meniscus tear (68.2%) is significantly lower than the medial meniscus tear (92.9%). The sensitivity of MRI for medial meniscus tear in ACL-deficient knee is lower than ACL-intact knees (90% vs. 96.2%, P = 0.3). Similarly, the sensitivity is significantly lesser for lateral meniscus tear in ACL-deficient knee compared to ACL-intact knee (50% vs. 83.3%, P = 0.009). The sensitivity of MRI for both the lateral and medial meniscus tear decreased if the MRI performed 3 months before the surgery. Conclusion: Patients with ACL-deficient knee have to be counseled for intraoperative detection of lateral meniscus tear as the sensitivity of MRI for lateral meniscus tear in ACL-deficient group is low. Similarly, if the MRI is more than 3 months old from the time of surgery, we recommend to repeat the MRI as the sensitivity decreases significantly.

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