Different patterns of lateral meniscus root tears in ACL injuries: application of a differentiated classification system

Forkel, Philipp; Reuter, Sven; Sprenker, Frederike; Achtnich, Andrea; Herbst, Elmar; Imhoff, Andreas B.; Petersen, Wolf

doi:10.1007/s00167-014-3467-6

Cited by 104 publications

(110 citation statements)

References 29 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…These findings have important implications on the treatment of ACL tears because of the relatively high percentage of patients who have LM posterior root tears associated with an ACL tear. 4,10,17 …”

Section: Discussionmentioning

confidence: 99%

Lateral Meniscus Posterior Root and Meniscofemoral Ligaments as Stabilizing Structures in the ACL-Deficient Knee: A Biomechanical Study

Frank

Moatshe

Brady

et al. 2017

Orthopaedic Journal of Sports Medicine

112

109

View full text Add to dashboard Cite

Background:The biomechanical effects of lateral meniscal posterior root tears with and without meniscofemoral ligament (MFL) tears in anterior cruciate ligament (ACL)–deficient knees have not been studied in detail.Purpose:To determine the biomechanical effects of the lateral meniscus (LM) posterior root tear in ACL-intact and ACL-deficient knees. In addition, the biomechanical effects of disrupting the MFLs in ACL-deficient knees with meniscal root tears were evaluated.Study Design:Controlled laboratory study.Methods:Ten paired cadaveric knees were mounted in a 6-degrees-of-freedom robot for testing and divided into 2 groups. The sectioning order for group 1 was (1) ACL, (2) LM posterior root, and (3) MFLs, and the order for group 2 was (1) LM posterior root, (2) ACL, and (3) MFLs. For each cutting state, displacements and rotations of the tibia were measured and compared with the intact state after a simulated pivot-shift test (5-N·m internal rotation torque combined with a 10-N·m valgus torque) at 0°, 20°, 30°, 60°, and 90° of knee flexion; an anterior translation load (88 N) at 0°, 30°, 60°, and 90° of knee flexion; and internal rotation (5 N·m) at 0°, 30°, 60°, 75°, and 90°.Results:Cutting the LM root and MFLs significantly increased anterior tibial translation (ATT) during a pivot-shift test at 20° and 30° when compared with the ACL-cut state (both Ps < .05). During a 5-N·m internal rotation torque, cutting the LM root in ACL-intact knees significantly increased internal rotation by between 0.7° ± 0.3° and 1.3° ± 0.9° (all Ps < .05) except at 0° (P = .136). When the ACL + LM root cut state was compared with the ACL-cut state, the increase in internal rotation was significant at greater flexion angles of 75° and 90° (both Ps < .05) but not between 0°and 60° (all Ps > .2). For an anterior translation load, cutting the LM root in ACL-deficient knees significantly increased ATT only at 30° (P = .007).Conclusion:The LM posterior root was a significant stabilizer of the knee for ATT during a pivot-shift test at lower flexion angles and internal rotation at higher flexion angles.Clinical Relevance:Increased knee anterior translation and rotatory instability due to posterior lateral meniscal root disruption may contribute to increased loads on an ACL reconstruction graft. It is recommended that lateral meniscal root tears be repaired at the same time as an ACL reconstruction to prevent possible ACL graft overload.

show abstract

Section: Discussionmentioning

confidence: 99%

Lateral Meniscus Posterior Root and Meniscofemoral Ligaments as Stabilizing Structures in the ACL-Deficient Knee: A Biomechanical Study

Frank

Moatshe

Brady

et al. 2017

Orthopaedic Journal of Sports Medicine

112

109

View full text Add to dashboard Cite

show abstract

“…Medial meniscus concomitant injuries are reported in 18%-54% of cases [4,46,49,50] and have a comorbidity to acute and chronic ACL tears of up to 90% [51] . A possible cause for this correlation in acute valgus-and internalrotational trauma could be the mechanism of sudden medial instability with subsequent anteroposterior and rotational shear forces when the ACL ruptures.…”

Section: Medial Meniscusmentioning

confidence: 99%

“…Lateral meniscus injuries are reported with concomitant rates of 17%-51% [4,46,49,50] , which is slightly less frequent than medial meniscus tears in cases of acute ACL rupture but also often caused by the typical valgusinternal-rotation trauma mechanism. The risk for a lateral meniscus injury seems to correlate with a coexisting lateral bone bruise, which is indicated on an MRI [46] .…”

Section: Lateral Meniscusmentioning

confidence: 99%

Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques

Domnick

Raschke

Herbort

2016

WJO

View full text Add to dashboard Cite

ligament (ACL) on kinematics and clinical outcomes have been investigated in many biomechanical and clinical studies over the last several decades. The knee is a complex joint with shifting contact points, pressures and axes that are affected when a ligament is injured. The ACL, as one of the intra-articular ligaments, has a strong influence on the resulting kinematics. Often, other meniscal or ligamentous injuries accompany ACL ruptures and further deteriorate the resulting kinematics and clinical outcomes. Knowing the surgical options, anatomic relations and current evidence to restore ACL function and considering the influence of concomitant injuries on resulting kinematics to restore full function can together help to achieve an optimal outcome. Conflict-of-interest statement:There are no conflicts of interest to declare. Open-Access:This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/ licenses/by-nc/4.0/ [1] . The ACL is a central ligament of the knee. The main functional role of the ACL is to provide stability against anterior tibial translation (ATT) and internal rotation. An acute ACL rupture is a common orthopedic trauma, with an estimated incidence of 78 per 100000 persons and a mean age of 32 years in Sweden and an estimated incidence of up to 84 per 100000 persons in the United States [2,3] . A common and frequent injury mechanism is noncontact combined valgus-and internal-rotation trauma [2,4] . Therefore, ACL injuries are often associated with other ligamentous injuries, such as a (partial) rupture of the medial collateral ligament (MCL) or the menisci. In addition, compression of the lateral condyle with a bone bruise or chondral lesion is often associated with the injury due to the valgus trauma. Persistent instability of the knee may be associated with long-term degenerative lesions. Surgical treatment of the ACL in the context of other injured structures and reconstruction of the intact joint kinematics are suggested to be the keys to a good clinical outcome [5,6] . ANATOMYThe ACL has its origin at the medial area of the lateral femoral condyle and inserts into the center of the eminentia of the tibia plateau next to the anterior horn of the lateral meniscus. The structure of the ACL has been described as two functional bundles: The anteromedial (AM) and the posterolateral (PL) bundle [7] . These two bundles have been associated with different roles in anteroposterior and complex-rotational stabilization of the joint [8][9][10] . The femoral origin was described as oval shaped with a longitudinal diameter of 18 mm and a width of approximately 11 mm [11,12] . ...

show abstract

“…Thus, the rate of meniscus injuries with ACL injury rests between 30 and 70%. Moreover, the medial meniscus is affected approximately twice as frequently as the lateral meniscus [9,11,18,24,36,50,55]. This is to be distinguished from "degenerative meniscus damage," in which tears develop within the meniscus without noteworthy trauma and under normal physiological stress.…”

Section: Introductionmentioning

confidence: 98%

The frequency of cartilage lesions in non-injured knees with symptomatic meniscus tears: results from an arthroscopic and NIR- (near-infrared) spectroscopic investigation

Spahn¹,

Plettenberg²,

Hoffmann³

et al. 2017

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Through our investigations, a high, if not complete, concomitance of degenerative cartilage lesions and degenerative meniscus damage was demonstrated. From this it can be concluded that the entity of "isolated degenerative meniscus damage" clearly does not exist in practice. It is therefore highly probable that degenerative meniscus lesions, as a part of general joint degeneration, are to be interpreted in the context of the development of arthrosis. The practical consequences still are unclear. Patients after partial meniscectomy need a longer follow-up to detect potential cartilage lesions as well as an OA progression.

show abstract

Different patterns of lateral meniscus root tears in ACL injuries: application of a differentiated classification system

Abstract: IV.

Cited by 104 publications

References 29 publications

Lateral Meniscus Posterior Root and Meniscofemoral Ligaments as Stabilizing Structures in the ACL-Deficient Knee: A Biomechanical Study

Lateral Meniscus Posterior Root and Meniscofemoral Ligaments as Stabilizing Structures in the ACL-Deficient Knee: A Biomechanical Study

Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques

The frequency of cartilage lesions in non-injured knees with symptomatic meniscus tears: results from an arthroscopic and NIR- (near-infrared) spectroscopic investigation

Contact Info

Product

Resources

About