A larger side-to-side difference in anterior knee laxity increases the prevalence of medial and lateral meniscal injuries in patients with ACL injuries

Nakamae, Atsuo; Sumen, Yoshio; Tsukisaka, Kazuhiro; Deie, Masataka; Fujimoto, Eisaku; Ishikawa, Masakazu; Omoto, Takenori; Adachi, Nobuo

doi:10.1007/s00167-021-06601-z

Cited by 8 publications

(5 citation statements)

References 41 publications

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“…Nevertheless, the impact of timing of surgery on meniscus damage in the isolated ACL reconstruction is well known in the literature. Many studies report a higher risk of overall meniscus tear, especially of the medial meniscus in delayed surgery compared to early surgery [6,8,10,[43][44][45][46]. The literature has widely demonstrated in long-term the superiority of meniscus repair in terms of function, return to sports and also cartilage protection, even more since high-energy knee injury increase the long-term risk of post-traumatic osteoarthritis [27,35,47,48].…”

Section: Discussionmentioning

confidence: 99%

Incidence and type of meniscal tears in multilligament injured knees

Labarre

Kim

Pujol

2022

Knee Surg Sports Traumatol Arthrosc

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PurposeMeniscal injuries occurring during multi‐ligament knee injuries (MLKI) are underreported. The purpose of this study was to compare the incidence and type of meniscal tears seen at the time of multi‐ligament reconstruction surgery compared to those occurring during isolated anterior cruciate ligament (ACL) surgery. MethodsPatients undergoing surgical treatment for MLKI and ACL‐only injuries between 2010 and 2020 were reviewed. Two‐hundred and thirty‐five patients were included in the MLKI group. There were 131 chronic injuries and 104 acute injuries. Two‐hundred and twenty‐two ACL‐only chronic injuries were used as a control group for comparison with the chronic MLKI group. Demographic data, type of meniscal tears, ligament injury patterns (Schenck classification) and time from injury to surgery were recorded. A delayed procedure was defined by a 4‐week interval after the knee injury. ResultsA meniscus was torn in 69 knees (29.4%): 36 knees (15.3%) with an isolated medial meniscus tear, 33 knees (17.9%) with an isolated lateral meniscus tear,.Nine knees (3.8%) had both menisci torn. MLKI with medial or lateral‐sided bicruciate ligament injuries (KDIIIM‐KDIIIL) were significantly associated with a lower rate of meniscal tears than knee injuries involving the ACL‐only and medial/lateral‐sided ligament injuries (KDI) (medial‐sided injuries p = 0.025; lateral‐sided injuries p = 0.049). Lateral‐sided injuries had significantly less meniscal damage than medial‐sided injuries: 22/124 (17.7%) vs. 41/100 (41%); (p < 0.001). No significant differences were found for frequency, type and distribution of meniscal tears between acute and chronic MLKI surgery. ACL‐only chronic injuries were associated with a higher rate of meniscal tears: 123/222 knees (55.4%) vs. 35/131 (26.9%) chronic MLKI; (p < 0.001), mainly involving the medial meniscus: 102/222 (46%) vs. 18/131 (13.7%); (p < 0.001). ConclusionsMeniscal tears were less common in the MLKI group than in the isolated ACL injury group. The degree of ligament injury patterns and the side of the injured collateral ligament influenced the type and incidence of meniscal damage. Contrary to isolated ACL injuries, a delayed procedure was not associated with a higher rate of meniscal lesions but did influence the type of treatment. Understanding of meniscal tears patterns in MLKI helps to improve the treatment management of these complex injuries.

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Section: Discussionmentioning

confidence: 99%

Incidence and type of meniscal tears in multilligament injured knees

Labarre

Kim

Pujol

2022

Knee Surg Sports Traumatol Arthrosc

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“…Fourteen cases including 9 patients suspected of ACL tears and 5 patients recovering after surgery were studied. The detailed clinical test results on these 14 cases using the Kneelax3 arthrometer and the WDS system are shown in Supplementary Table 3.…”

Section: Resultsmentioning

confidence: 99%

High-Precision Wearable Displacement Sensing System for Clinical Diagnosis of Anterior Cruciate Ligament Tears

Yang

et al. 2023

ACS Nano

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An anterior cruciate ligament (ACL) tear is a common musculoskeletal injury with a high incidence. Traditional diagnosis employs magnetic response imaging (MRI), physical testing, or other clinical examination, which relies on complex and expensive medical instruments, or individual doctoral experience. Herein, we propose a wearable displacement sensing system based on a grating-structured triboelectric stretch sensor to diagnose the ACL injuries. The stretch sensor exhibits a high resolution (0.2 mm) and outstanding robustness (over 1,000,000 continuous operation cycles). This system is employed in clinical trial to diagnose ACL injuries. It measures the displacement difference between the affected leg and the healthy leg during Lachman test. And when such a difference is greater than 3 mm, the ACL is considered to be at risk for injury or tear. Compared with the gold standard of arthroscopy, the consistency rate of this wearable diagnostic system reached about 85.7%, which is higher than that of the Kneelax3 arthrometer (78.6%) with a large volume. This shows that the wearable system possesses the feasibility to supplement and improve existing arthrometers for facile diagnosing ACL injuries. It may take a promising step for wearable healthcare.

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“…This study is the first to investigate the relationship between the high‐grade pivot‐shift phenomenon and the asymmetry of L‐ATT and M‐ATT. The definition of ATT was proposed to represent the relationship between the tibia and femur [8], and has been used in the evaluation of knee stability and clinical outcomes before and after ACLR [2, 6, 23, 25]. Song et al [29] investigated the relationship between excessive ATT and clinical outcomes after ACLR and found that excessive preoperative ATT after ACL injury was associated with greater rotatory knee laxity two years after anatomic ACLR.…”

Section: Discussionmentioning

confidence: 99%

High-grade pivot-shift phenomenon after anterior cruciate ligament injury is associated with asymmetry of lateral and medial compartment anterior tibial translation and lateral meniscus posterior horn tears

Guo

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeTo investigate whether the high‐grade pivot‐shift phenomenon is associated with asymmetry of the lateral and medial compartment anterior tibial translation (L‐ATT and M‐ATT) and lateral meniscus posterior horn (LMPH) tears in anterior cruciate ligament (ACL) injuries. MethodsA retrospective analysis was performed on 192 consecutive patients who had complete ACL injuries between January 2019 and December 2020. Among these, 156 met the inclusion criteria. L‐ATT and M‐ATT were measured using preoperative weight‐bearing magnetic resonance imaging (MRI), and the differences between L‐ATT and M‐ATT were calculated. Thirty‐five patients who demonstrated excessive differences in L‐ATT and M‐ATT (> 6.0 mm) were regarded as asymmetric (study group), and 36 patients with minimal or no differences in L‐ATT and M‐ATT (< 3.0 mm) were allocated to the control group. Demographic data, grade of the pivot‐shift test, integrality of LMPH, and medial meniscus posterior horn (MMPH) were compared between the groups. Moreover, predictors of high‐grade pivot‐shift phenomenon, including asymmetry of L‐ATT and M‐ATT, integrity of LMPH and MMPH, time from injury to surgery, sex, age, and body mass index (BMI) were assessed using multivariable logistic regression analysis. ResultsThe difference between L‐ATT and M‐ATT in the study group was significantly higher than that in the control group (mean ± SD: 8.4 ± 2.1 mm vs. 1.5 ± 1.0 mm, P < 0.001). A higher proportion of patients with high‐grade pivot‐shift phenomenon (2 + and 3 +) and LMPH tears were identified in the study group (high‐grade pivot‐shift phenomenon: 25/35 vs. 13/36, P = 0.003; LMPH tears: 18/35 vs. 5/36, P = 0.001). Additionally, asymmetry of L‐ATT, M‐ATT (odds ratio 5.8; 95% CI 1.7–19.8; P = 0.005), and LMPH tears (odds ratio 3.8; 95% CI 1.3–11.6; P = 0.018) were found to be good predictors of the high‐grade pivot‐shift phenomenon after ACL injury, whereas MMPH tears, time from injury to surgery, sex, age, and BMI were not. ConclusionIn patients with ACL injury, the high‐grade pivot‐shift phenomenon is associated with asymmetry between L‐ATT and M‐ATT, and LMPH tears. Level of evidenceIII.

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A larger side-to-side difference in anterior knee laxity increases the prevalence of medial and lateral meniscal injuries in patients with ACL injuries

Cited by 8 publications

References 41 publications

Incidence and type of meniscal tears in multilligament injured knees

Incidence and type of meniscal tears in multilligament injured knees

High-Precision Wearable Displacement Sensing System for Clinical Diagnosis of Anterior Cruciate Ligament Tears

High-grade pivot-shift phenomenon after anterior cruciate ligament injury is associated with asymmetry of lateral and medial compartment anterior tibial translation and lateral meniscus posterior horn tears

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