What is the terrible triad?

Barber, F. Alan

doi:10.1016/0749-8063(92)90130-4

Cited by 41 publications

(32 citation statements)

References 5 publications

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“…Since the instigation of advanced clinical diagnosis and especially arthroscopic diagnosis, the existence of the 'unhappy triad' has been criticized and denied. On the basis of arthroscopic examination of simultaneous acute ruptures of the ACL and MCL, the third component of the 'unhappy triad' was revealed to be the LM [2]. The most frequent type of LM tear is the longitudinal one, being found in 50% of all cases.…”

Section: Discussionmentioning

confidence: 99%

Lateral meniscal tears and their evolution in acute injuries of the anterior cruciate ligament of the knee

Nikolić

1998

Knee Surgery, Sports Traumatology, Arthroscopy

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Arthroscopic diagnosis was used to determine the incidence of the most frequent injuries to the knee's internal structures associated with ACL tear as well as ones without ACL tear. The most frequent finding associated with a recent ACL tear was the LM tear (72.7%). There is a statistically significant incidence of recent LM tear in knees with a recent ACL tear compared with recently injured knees without an ACL tear (P < 0.001). A statistically significant incidence of longitudinal LM tear was found in knees with a recent ACL tear compared with recently injured knees without an ACL tear (P < 0.001). Longitudinal tears were present in 63.6% of the knees with a recent ACL tear or in 87.5% of all knees with a recent LM tear. No statistically significant difference was found in the incidence of LM tear in the knees with a recent ACL tear compared to the incidence of LM tear in knees with an old ACL tear (P > 0.05). The posterior horn was most frequently injured (71.5% vs 64.0%). A significant difference between the findings in the various patient groups studied supports the hypothesis that longitudinal LM tears in an ACL-deficient knee do not involve secondary meniscal pathology but that their onset derives from a primary recent injury. Most probably, the recent LM lesion does not evolve in meniscal length and depth. This hypothesis needs thorough investigation.

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Section: Discussionmentioning

confidence: 99%

Lateral meniscal tears and their evolution in acute injuries of the anterior cruciate ligament of the knee

Nikolić

1998

Knee Surgery, Sports Traumatology, Arthroscopy

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“…In September 2014, the American Academy of Orthopaedic Surgeons developed evidence-based treatment guidelines regarding ACL tears [41]. They found that "[m]oderate evidence supports surgical reconstruction in active young adult [20,26,28,[30][31][32][33]39,[42][43][44][45][46][47][48][49][50][51] patients with an ACL tear" and "limited evidence [sic] supports non-surgical management for less active patients with less laxity". Rather than using a strict age or activity level cutoff for determination of treatment, orthopedic surgeons often make recommendations based upon the physiological age of the patient [52].…”

Section: Surgical Versus Conservative Treatmentmentioning

confidence: 99%

“…O'Donoghue first described the "unhappy triad" in 1950, in which he described an ACL tear, a medial collateral ligament (MCL) tear, and medial meniscal injury [28]. Despite this initial description; when an ACL tear is present with a combined MCL ligament tear, the lateral meniscus is more likely to be injured than the medial meniscus [28]. These findings are currently the accepted concept of the unhappy triad, which occurs commonly after an athlete sustains a blow to the knee.…”

Section: Evaluating For Associated Injuriesmentioning

confidence: 99%

“…ACL tears are mostly associated with meniscal injuries, with a high prevalence of 60%-75% [27,[24][25][26]. O'Donoghue first described the "unhappy triad" in 1950, in which he described an ACL tear, a medial collateral ligament (MCL) tear, and medial meniscal injury [28]. Despite this initial description; when an ACL tear is present with a combined MCL ligament tear, the lateral meniscus is more likely to be injured than the medial meniscus [28].…”

Section: Evaluating For Associated Injuriesmentioning

confidence: 99%

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State-of-the-art anterior cruciate ligament tears: A primer for primary care physicians

Salzler

Nwachukwu

Rosas

et al. 2015

The Physician and Sportsmedicine

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The purpose of this article is to provide primary care physicians and other members of the medical community with an updated, general review on the subject of anterior cruciate ligament (ACL) tears. We aim to enhance awareness of these injuries and to prepare those practicing in the primary care setting to address these injuries. Because ACL injuries are quite common, it is very likely that a primary care physician will encounter these injuries and need to address them acutely. The current literature is replete with new concepts and controversies regarding ACL injuries, and this article provides a concise review for our target audience in regard to the care of a patient with an ACL injury. This article is composed of an overview with current epidemiologic data, basic anatomy and physiology, clinical presentation, physical examination findings, imaging modalities, and treatment options. After reading this short article, a medical care provider should understand ACL injuries and their appropriate management.

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“…The O'Donaghue Bunhappy triad^described a tear of the ACL in conjunction with tears of the MCL and medial meniscus. 63 However, this pattern of injury is actually extremely uncommon, with lateral meniscal tears occurring more frequently than medial meniscal tears. 16,63 Dislocations of the knee usually result in multiple ligament tears as well as injuries to the joint capsule, muscle, tendons, and neurovascular bundles (Fig.…”

Section: Ligamentous Injuriesmentioning

confidence: 99%

Anterior Cruciate Ligament Tears and Associated Injuries

Stevens

Dragoo²

2006

Topics in Magnetic Resonance Imaging

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Anterior cruciate ligament (ACL) tears are a commonly sustained sports injury, often occurring in association with meniscal tears and trauma to other ligamentous structures around the knee. Diagnosis can often be made clinically, but assessment may be difficult in the acute setting when there is a large joint effusion and severe pain. Plain radiographs may detect the presence of a joint effusion and any associated fractures. However, magnetic resonance imaging is vital for assessing acute knee injuries and plays an important role in deciding treatment options and planning surgical intervention. Some of the associated meniscal and ligamentous injuries can be subtle and may easily be overlooked if these structures are not scrutinized closely. This article will discuss the anatomy of the ACL and the mechanisms and initial clinical assessment of ACL injuries, and review the imaging features of ACL tears and some of the associated injuries, including the posterolateral corner structures. These associated injuries have important implications for determining treatment options and subsequent return to athletic activities.

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What is the terrible triad?

Cited by 41 publications

References 5 publications

Lateral meniscal tears and their evolution in acute injuries of the anterior cruciate ligament of the knee

Lateral meniscal tears and their evolution in acute injuries of the anterior cruciate ligament of the knee

State-of-the-art anterior cruciate ligament tears: A primer for primary care physicians

Anterior Cruciate Ligament Tears and Associated Injuries

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