Meniscal Lesions Associated with Anterior Cruciate Ligament Injury

Warren, Russell F.; Levy, I. Martin

doi:10.1097/00003086-198301000-00008

Cited by 93 publications

(64 citation statements)

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“…Whether or not the posterior horn of the meniscus acts as restraint to the substantial anterior translation produced by the transition from nonweightbearing to weightbearing for knees with ACL tears in vivo remains unknown. However, when one considers that the incidence of concomitant meniscal tears associated with chronic ACL tears ranges between 53% and 100?4 [14,15,28,29] in combination with our observation of a fourfold increase of anterior translation of the tibia relative to the femur for knees with ACL tears compared to normal, it supports the hypothesis that the increased translation is resisted by the posterior horns of the menisci, exposing these structures to increased strain, and in turn, this could produce tears that alter their load bearing function.…”

Section: Discussionmentioning

confidence: 99%

Chronic anterior cruciate ligament deficiency is associated with increased anterior translation of the tibia during the transition from non‐weightbearing to weightbearing

Beynnon

Fleming

Labovitch

et al. 2002

Journal Orthopaedic Research

108

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Translation of the tibia relative to the femur was measured while a group of subjects with normal knees and group with anterior cruciate ligament (ACL) tears underwent transition from non-weightbearing to weightbearing stance. Subjects were positioned in the Vermont knee laxity device (VKLD) with muscles relaxed and the limb segment and compressive joint load offset (nonweightbearing). A lateral radiograph of the knee, with the posterior aspects of the femoral condyles superimposed, was obtained to document the position of the tibia relative to the femur. Immediately after, a compressive load equal to 40% of bodyweight was applied to each foot, and a second radiograph was obtained to document the change in position of the tibia relative to the femur. The transition from non-wcightbearing to weightbearing produced a significant increase of anterior translation of the tibia relative to the femur (mean; 3.4 mm) for the subjects with ACL tears compared with the contralateral normal knees (0.8 mm). Similarly, there was a significant increase in anterior translation of the tibia for the subjects with ACL tears compared to the group of subjects with normal knees (1.2 mm). The fourfold increase in anterior translation of the tibia for the knees with ACL tears compared to the contralateral side is a concern because it is substantially greater than the 95% confidence limits of the side-to-side differences in anterior-posterior knee laxity measured from subjects with normal knees. This observation could explain, at least in part, one of the mechanisms that initiates damage to the meniscus and articular cartilage in subjects that have suffered an ACL tear.

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Section: Discussionmentioning

confidence: 99%

Chronic anterior cruciate ligament deficiency is associated with increased anterior translation of the tibia during the transition from non‐weightbearing to weightbearing

Beynnon

Fleming

Labovitch

et al. 2002

Journal Orthopaedic Research

108

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“…In addition, there was a higher rate of medial meniscus injuries (60%) as compared to lateral meniscus injuries (40%). This finding seems to reflect the distribution of meniscus injuries seen in chronically injured ACLs (24)(25)(26)(27)(28). This has been attributed to differences in translation patterns of the medial femoral condyle on the meniscal-tibial plateau in an ACL injured knee as compared to a healthy knee (23,29,30).…”

Section: Discussionmentioning

confidence: 71%

Injury patterns in patients presenting with a recurrent anterior cruciate ligament tear following primary reconstruction

et al. 2016

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Background: An anterior cruciate ligament (ACL) graft rupture or a primary ACL injury in the contralateral knee is one of the greatest concerns of patients following primary anterior cruciate ligament reconstruction (ACLR). Our study describes the epidemiology and presence of concomitant meniscal injuries of patients with a graft rupture following primary ACLR or a primary rupture of the contralateral ACL following primary ACLR of the ipsilateral knee. Methods:We reviewed the medical records of 42 patients who underwent a second ACLR. ACLR was performed using the ipsilateral semitendinosus and gracilis autograft. Variables extracted included the presence of concomitant MM and LM injuries intra-operatively, the patients' level of intensity of sport (light, moderate, strenuous), duration of rehabilitation and mechanism of injury (contact, non-contact).Results: Twenty-four (57.1%) patients had graft rupture of a previously reconstructed ACL of which 20 (83.3%) were male and 18 (42.9%) patients had a primary ACL tear of the contralateral knee following ACLR of the ipsilateral knee of which 18 (100%) were male. Patient who sustained a graft rupture were younger (29.5 vs.31.9 years), had a higher body mass index (BMI) (26.42 vs. 25.10 kg/m 2 ) and had a longer time before re-injury (6.18 vs. 4.94 years). Concomitant meniscal injury rates were comparable in both groups and the medial meniscus was injured more often.Conclusions: This study describes the demographics of 2 nd ACL injuries in the Asian population. Additional studies that investigate the differences in knee anatomy of Asians and Caucasians and their impact on ACL injuries should be performed.

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“…Since the 1970s and 1980s, the menisci have been recognized as critical secondary stabilizers [80][81][82][83][84], with the medial meniscus acting as a • High load-to-failure and stiffness…”

Section: Associated Soft Tissue Injuriesmentioning

confidence: 99%

Kinematic outcomes following ACL reconstruction

Naendrup

Zlotnicki

Chao

et al. 2016

Curr Rev Musculoskelet Med

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Anterior cruciate ligament (ACL) reconstruction aims to restore the translational and rotational motion to the knee joint that is lost after injury. However, despite technical advancements, clinical outcomes are less than ideal, particularly in return to previous activity level. A major issue is the inability to standardize treatment protocols due to variations in materials and approaches used to accomplish ACL reconstruction. These include surgical techniques such as the transtibial and anteromedial portal methods that are currently under use and the wide availability of graft types that will be used to reconstruct the ACL. In addition, concomitant soft tissue injuries to the menisci and capsule are frequently present after ACL injury and, if left unaddressed, can lead to persistent instability even after the ACL has been reconstructed. Advances in the field of biomechanics that help to objectively measure motion of the knee joint may provide more precise data than current subjective clinical measurements. These technologies include extra-articular motion capture systems that measure the movement of the tibia in relation to the femur. With data gathered from these devices, a threshold for satisfactory knee stability may be established in order to correctly identify a successful reconstruction following ACL injury.

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Meniscal Lesions Associated with Anterior Cruciate Ligament Injury

Cited by 93 publications

References 0 publications

Chronic anterior cruciate ligament deficiency is associated with increased anterior translation of the tibia during the transition from non‐weightbearing to weightbearing

Chronic anterior cruciate ligament deficiency is associated with increased anterior translation of the tibia during the transition from non‐weightbearing to weightbearing

Injury patterns in patients presenting with a recurrent anterior cruciate ligament tear following primary reconstruction

Kinematic outcomes following ACL reconstruction

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