Different patterns of meniscal tears in acute anterior cruciate ligament (ACL) ruptures and in chronic ACL-deficient knees

Cipolla, Massimo; Scala, Arianna; Giannì, E; Puddu, Giancarlo

doi:10.1007/bf01565470

Cited by 156 publications

(132 citation statements)

References 12 publications

Supporting

Mentioning

120

Contrasting

Unclassified

Order By: Relevance

“…First, surgical timing must be discussed. Most surgeons would agree that ACL reconstruction should only be performed once full motion has been regained, unless in the setting of a tibial eminence fracture or a bucket-handle meniscus tear [46,47] (Cipolla M KSSTA 1995, Shelbourne KD AJSM 1991). Recently a report of increased risk of meniscal damage with delay in treatment of greater than 12 weeks may indicate that these injuries ought to be treated more urgently, however [48••].…”

Section: Operativementioning

confidence: 99%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

The anterior cruciate ligament (ACL) is a stabilizing structure to both anterior translation of the tibia with respect to the femur as well as rotation of the knee joint. Children and adolescents are susceptible to these injuries, and there are some who believe the incidence of ACL injuries in this population is increasing due to year round single sport participation. Pediatric ACL injuries are typically seen in several forms: tibial avulsion fractures, partial ACL tears, and full thickness ligament tears. There were and still are some who feel that ACL injuries should be treated non-operatively in the pediatric and adolescent population; however, recent literature refutes this notion. Several factors must be considered during pediatric and adolescent ACL reconstruction, each of which will be examined in this manuscript, including: status of the physis, reconstruction technique, and graft source.

show abstract

Section: Operativementioning

confidence: 99%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

show abstract

“…D. Guenther, V. Swami, S. S. Dhillon, J. L. Jaremko (&) Department of Radiology and Diagnostic Imaging, University of Alberta, 2A2.42 Walter Mackenzie Health Sciences Centre, Edmonton, AB T6G 2B7, Canada e-mail: jjaremko@ualberta.ca are associated with increased risk of injury to menisci, which normally transmit load and absorb shocks between the femur and tibia [37]. With each episode of giving way, meniscal tears can become more complex and less amenable to repair [8]. Studies in adult patients [7,8,24,39] and in pediatric patients [12,28,32] have shown an increased incidence of medial meniscal tears with delayed ACL reconstruction.…”

Section: Introductionmentioning

confidence: 99%

“…With each episode of giving way, meniscal tears can become more complex and less amenable to repair [8]. Studies in adult patients [7,8,24,39] and in pediatric patients [12,28,32] have shown an increased incidence of medial meniscal tears with delayed ACL reconstruction. Although the treatment of ACL tears in skeletally immature patients remains controversial [33], the risk of physeal injury and resulting growth disturbance from ACL repair to a patient with open physes is now thought to be small [15,22], and many centers (including our institution) opt for prompt reconstruction before skeletal maturity [9,16,20,25,31,34,40].…”

Section: Introductionmentioning

confidence: 99%

Meniscal Injury After Adolescent Anterior Cruciate Ligament Injury: How Long Are Patients at Risk?

Guenther

Swami

Dhillon

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Delay of as much as 5 months between ACL injury and surgery is known to be associated with increased risk of a medial meniscal tear, but the risk of additional meniscal tear progression with a longer delay to surgery is unclear. Questions/purposes We determined the (1) times of injury, MRI, and surgery in adolescents with ACL tears, and whether (2) timing of surgery, or (3) initial integrity of the meniscus seen on MR images predicted development of meniscal tears. Methods We reviewed 112 adolescents who were 15 ± 1 years old (mean ± SD) (range, 11-16 years) with a torn ACL. These patients underwent surgical repair from 2005 to 2011 in a Canadian city. We compared dates of injury, MRI, and surgery. A pediatric and musculoskeletal fellowship-trained radiologist reread the MR images, and meniscal injuries were graded according to severity. This was compared with surgical findings described in the operative report. Results Time after injury to MRI and surgery averaged 77 days (range, 1-377 days) and 342 days (range, 42-1637 days), respectively. Patients with new or worsened medial meniscal tears had waited longer for surgery (445 versus 290 days; p = 0.002). Bucket handle medial meniscal tears were more common in patients with surgery more than 1 year after injury than others (15 of 34 versus 14 of 75; p = 0.013). A medial meniscal tear observed on MR images was a significant covariate for a torn meniscus at surgery (relative risk, 5.7; 95% CI, 2.8-11.6). Medial meniscal survival continued to decline sharply greater than 1 year after injury. Conclusions Medial meniscal tears, especially bucket handle tears, increased steadily in frequency more than 1 year after ACL injury. Timely ACL reconstruction may be warranted to reduce the risk of further medial meniscal damage even in patients whose original injury occurred more than 1 year before. Level of Evidence Level IV, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.

show abstract

“…However, several reports have found similar patterns of meniscal injury in the anterior cruciate deficient knee. 2,3 In those reports, in acute cases of ACL injury the rates of meniscal injury were 28.5 to 44% for the medial meniscus and 56 to 61% for the lateral meniscus. In chronic cases the rate of the medial meniscal injury was 70% to 74.5% and that of the lateral meniscus was 30% to 41.6%.…”

Section: Discussionmentioning

confidence: 95%

Meniscal Tearing after ACL Reconstruction

Ichinohe

Yoshida

Murakami

et al. 2000

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

The knees of 72 patients with unilateral anteriorcruciate-ligament (ACL) injury were analyzed before ACL reconstruction as well as by follow-up arthroscopy on the day of staple removal. At ACL reconstruction 31 lateral menisci and 40 medial menisci were found to be normal. 28 lateral menisci and 24 medial menisci were treated surgically, while 13 lateral menisci and 8 medial menisci with small or incomplete meniscal tearing were not treated.At follow-up arthroscopy there were 3 new cases of lateral meniscal tearing and 3 new cases of medial meniscal tearing in the groups diagnosed as normal prior to surgery. Two of the 13 cases with small or incomplete lateral meniscal tearing required resection, 8 healed and the other 3 demonstrated no progressive change. Four of the 8 cases with small or incomplete medial meniscal tears healed, 3 exhibited no progressive change and one required surgical treatment. There was no correlation between meniscal tearing and knee instability as indicated by a positive Lachman test or a positive pivot shift sign.The results of the present study indicate that ACL reconstruction prevents progressive changes in meniscal tears and will prevent secondary osteoarthritis, and that some small tears of the lateral meniscus require no surgical treatment.

show abstract

Different patterns of meniscal tears in acute anterior cruciate ligament (ACL) ruptures and in chronic ACL-deficient knees

Cited by 156 publications

References 12 publications

Pediatric ACL injuries: evaluation and management

Pediatric ACL injuries: evaluation and management

Meniscal Injury After Adolescent Anterior Cruciate Ligament Injury: How Long Are Patients at Risk?

Meniscal Tearing after ACL Reconstruction

Contact Info

Product

Resources

About