Association of meniscal tears with cruciate ligament injuries
Aim: To find the association of meniscal tears with isolated and combined cruciate ligament injuries, grades of injury, time of injury and type of injury.
Method: Magnetic resonance (MR) imaging of 240 patients with knee pain who diagnosed with anterior cruciate ligament (ACL) and Posterior Cruciate Ligament (PCL) injury by arthroscopy were studied.
Results: Road and traffic accidents (RTA) caused in 80.4% of cases. A total of 192 patients (80%) with isolated ACL involvement, seven patients (2.9%) with isolated PCL involvement, and 41 patients (17%) with combined ACL and PCL involvement. In cases with ACL involvement (n=192), 17 patients (8.8%) had grade 1 injury: sprain, 82 patients (42.7%) had grade 2/3 injury: partial tear and 93 patients (48.4%) had grade 4 injury: complete tear. Among partial ACL tear, lateral meniscus involvement was predominant in 45 patients (54.8%), whereas medial meniscus was involved in 26 patients (31.7%) and normal meniscus was observed in 19 patients (23.1%). In lateral meniscus, the anterior horn was majorly involved 36 patients (80%) as compared to posterior horn in 15 patients (33.3%).
Conclusion: The present study indicates that the anterior horn of the lateral meniscus was predominantly involved in patients with isolated ACL and combined injury of ACL and PCL. The posterior horn of the medial meniscus was more commonly involved in chronic injury of ACL, whereas the posterior horn of the lateral meniscus was involved in acute ACL injury. Early ACL reconstruction is recommended for the prevention of secondary meniscal tears.
Hayashi D, Li X, Murakami AM, Roemer FW, Trattnig S, Guermazi A. Understanding magnetic resonance imaging of knee cartilage repair: a focus on clinical relevance. Cartilage. 2018;9(3):223-36. DOI 10.1177/1947603517710309
Crawford R, Walley G, Bridgman S, Maffulli N. Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review. British medical bulletin. 2007;84(1):5-23. DOI 10.1093/bmb/ldm022
Bhatia S. LaPrade CM, Ellman MB, LaPrade RF, Meniscal root tears: Significance, diagnosis and treatment. Am J Sports Med 2014:42.3016-30 DOI 10.1177/0363546514524162
Chung KS, Ha JK, Ra HJ, Kim JG. A meta-analysis of clinical and radiographic outcomes of posterior horn medial meniscus root repairs. Knee Surgery, Sports Traumatology, Arthroscopy. 2016;24(5):1455-68. DOI: 10.1007/s00167-015-3832-0
Kim JG, Lee YS, Bae TS, Ha JK, Lee DH, Kim YJ, et al. Tibiofemoral contact mechanisms following posterior root of medial meniscus tear, repair, meniscectomy and allograft transplantation. Knee Surg Sports Traumatol Arthrose 2013; 21:2121-5. DOI 10.1007/s00167-012-2182-4
Reid CR, Bush PM, Cummings NH, McMullin DL, Durrani SK. Areview of occupational knee disorders. J Occupational rehabilitation 2010;20:489-501. DOI 10.1007/s10926-010-9242-8
Griffin LY, Agel J, Albohm MJ, et al. Non-contact anterior cruciate ligament injuries: risk factors and prevention strategies. J Americam Academy Orthopaedic Surgery 2000; 8(3):141-150. DOI 10.5435/00124635-200005000-00001
Noyes FR, Barber-Westin SD. Treatment of meniscus tears during anterior cruciate ligament reconstruction. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2012;28(1):123-30. DOI 10.1016/j.arthro.2011.08.292
Louw QA, Manilall J, Grimmer KA. Epidemiology of knee injuries among adolescents: a systematic review. British journal of sports medicine. 2008;42(1):2-10. DOI 10.1136/bjsm.2007.035360
Hamada M, Shino K, Mitsuoka T, Toritsuka Y, Natsu-Ume T, Horibe S. Chondral injury associated with acute isolated posterior cruciate ligament injury. Arthroscopy 2000;16(1):59-63. DOI 10.1016/s0749-8063(00)90128-2
Hong SH, Choi JY, Lee GK, Choi JA, Chung HW, Kang HS. Grading of anterior cruciate ligament injury: diagnostic efficacy of oblique coronal magnetic resonance imaging of the knee. Journal of computer assisted tomography. 2003;27(5):814-9. DOI 10.1097/00004728-200309000-00022
Chagas-Neto FA, Nogueira-Barbosa MH, Lorenzato MM, Salim R, Kfuri-Junior M, Crema MD. Diagnostic performance of 3D TSE MRI versus 2D TSE MRI of the knee at 1.5 T, with prompt arthroscopic correlation, in the detection of meniscal and cruciate ligament tears. Radiologia brasileira. 2016;49:69-74. DOI 10.1590%2F0100-3984.2015.0042
MacMahon PJ, Palmer WE. A biomechanical approach to MRI of acute knee injuries. American Journal of Roentgenology. 2011;197(3):568-77. DOI 10.2214/ajr.11.7026
Hayes CW, Brigido MK, Jamadar DA, Propeck T. Mechanism-based pattern approach to classification of complex injuries of the knee depicted at MR imaging. Radiographics. 2000;20(1):S121-34. DOI 10.1148/radiographics.20.suppl_1.g00oc21s121
Chaddia AM, Inacio MC, Malleris GB. Are meniscus and cartilage injuries related to time of ACL reconstruction? Am J Sports Med.2011;39:1894-9. DOI 10.1177/0363546511410380
Dekker TJ, Rush JK, Schmitz MR. What's New in Pediatric and Adolescent Anterior Cruciate Ligament Injuries? J Pediatr Orthop. 2018;38(3):185-192. DOI 10.1097/bpo.0000000000000792
Pujol N, Colombet P, Cucurulo T, Graveleau N, Hulet C, Panisset JC, Potel JF, Servien E, Sonnery-Cottet B, Trojani C, Djian P. Natural history of partial anterior cruciate ligament tears: a systematic literature review. Orthopaedics & Traumatology: Surgery & Research. 2012;98(8):S160-4. DOI 10.1016/j.otsr.2012.09.013
Chen G, Tang X, Li Q, Zheng G, Yang T, Li J. The evaluation of patient-specific factors associated with meniscal and chondral injuries accompanying ACL rupture in young adult patients. Knee Surgery, Sports Traumatology, Arthroscopy. 2015;23(3):792-8. DOI 10.1007/s00167-013-2718-2
Feucht MJ, Bigdon S, Bode G, Salzmann GM, Dovi-Akue D, Südkamp NP, Niemeyer P. Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. Journal of orthopaedic surgery and research. 2015;10(1):1-8. DOI: 10.1186/s13018-015-0184-x
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