DIAGNOSTIC SIGNIFICANCE OF MEDIAL MENISCUS INJURY IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION FAILURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHENGCong ¹ , RENShiyou ¹ , CHENPeng ² , JIANGChangqing ² ,  ZHANGWentao ²

1. Clinical College, Anhui Medical University & Peking University Shenzhen Hospital, Shenzhen Guangdong, 518036, P. R. China;
2. Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital;

Corresponding author：

ZHANGWentao, Email: Zhangwt2007@sina.cn

Keywords：

Anterior cruciate ligament reconstruction; Tibial anterior displacement; Medial meniscus injury; Diagnosis; MRI

DOI：

10.7507/1002-1892.20160113

Video：

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Objective To explore the relationship between anterior cruciate ligament (ACL) reconstruction failure and medial meniscus injury and decide whether medial meniscus injury could be the judgment index for ACL reconstruction failure without trauma history. Methods Between March 2011 and December 2015, 117 patients underwent ACL reconstruction, and the clinical data were analyzed retrospectively. All patients had no trauma history after ACL resconstruction. MRI examination showed medial meniscus injury in 56 cases (observation group) and no medial meniscus injury in 61 cases (control group). There was no significant difference in gender, age, side, reconstructive surgery, and follow-up time between 2 groups (P>0.05). The KT-2000 arthrometer was used to measure the difference value of tibial anterior displacement between two knees in 30° knee flexion. Then wether the ACL reconsruction failure was judged according to the evaluation criteria proposed by Rijke et al. Results In observation group, the difference value of tibial anterior displacement was <3 mm in 7 patients, 3-5 mm in 11 patients, and >5 mm in 38 patients. In control group, the difference value of tibial anterior displacement was <3 mm in 31 patients, 3-5 mm in 18 patients, and >5 mm in 12 patients. The ACL reconstruction failure rate of observation group (67.9%) was significantly higher than that of control group (19.7%) (χ²=27.700, P=0.000). Conclusion After ACL reconstruction, medial meniscus injury occurs under no trauma history circumstances, indicating ACL reconstruction failure.

Citation： CHENGCong, RENShiyou, CHENPeng, JIANGChangqing, ZHANGWentao. DIAGNOSTIC SIGNIFICANCE OF MEDIAL MENISCUS INJURY IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION FAILURE. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(5): 558-561. doi: 10.7507/1002-1892.20160113 Copy

1.	Henning CE. Current status of meniscus salvage. Clin Sports Med, 1990, 9(3):567-576.
2.	Murawski CD, Wolf MR, Araki D, et al. Anatomic anterior cruciate ligament reconstruction:current concepts and future perspective. Cartilage, 2013, 4(3 Suppl):27S-37S.
3.	Indelicato PA, Bittar ES. A perspective of lesions associated with ACL insufficiency of the knee. A review of 100 cases. Clin Orthop Relat Res, 1985, (198):77-80.
4.	Rijke AM, Perrin DH, Goitz HT, et al. Instrumented arthrometry for diagnosing partial versus complete anterior cruciate ligament tears. Am J Sports Med, 1994, 22(2):294-298.
5.	Marcacci M, Bonanzinga T, Grassi A, et al. Long-term clinical outcomes of combined BPTB ACL reconstruction and popliteus tendon plasty. Knee Surg Sports Traumatol Arthrosc, 2015, 23(10):2930-2935.
6.	Kim SJ, Kim HK. Reliability of the anterior drawer test, the pivot shift test, and the Lachman test. Clin Orthop Relat Res, 1995, (317):237-242.
7.	Mulligan EP, McGuffie DQ, Coyner K, et al. The reliability and diagnostic accuracy of assessing the translation endpoint during the lachman test. Int J Sports Phys Ther, 2015, 10(1):52-61.
8.	Stanev D, Moustakas K, Gliatis J, et al. ACL reconstruction decision support. Personalized simulation of the Lachman test and custom activities. Methods Inf Med, 2016, 55(1):98-105.
9.	Yaqoob J, Alam MS, Khalid N. Diagnostic accuracy of Magnetic Resonance Imaging in assessment of Meniscal and ACL tear:Correlation with arthroscopy. Pak J Med Sci, 2015, 31(2):263-268.
10.	Murase Ki K, Takahei T, Obata H, et al. Anterior cruciate ligament reconstruction with a multistrand hamstring graft fixed with a Ligament Tension Screw:a new device that can be used to readjust graft tension after fixation. J Orthop Sci, 2002, 7(1):48-55.
11.	Papastergiou SG, Koukoulias NE, Mikalef P, et al. Meniscal tears in the ACL-deficient knee:correlation between meniscal tears and the timing of ACL reconstruction. Knee Surg Sports Traumatol Arthrosc, 2007, 15(12):1438-1444.
12.	Tandogan RN, Taşer O, Kayaalp A, et al. Analysis of meniscal and chondrallesions accompanying anterior cruciate ligament tears:relationshipwith age, time from injury, and level of sport. Knee Surg Sports Traumatol Arthrosc, 2004, 12(4):262-270.
13.	Todor A, Nistor D, Buescu C, et al. Incidence and treatment of intra-articular lesions associated with anterior cruciate ligament tears. Clujul Med, 2014, 87(2):106-108.
14.	Dürselen L, Vögele S, Seitz AM, et al. Anterior knee laxity increases gapping of posterior horn medial meniscal tears. Am J Sports Med, 2011, 39(8):1749-1755.
15.	Markolf KL, Jackson SR, McAllister DR. Force measurements in the medial meniscus posterior horn attachment:effects of anterior cruciate ligament removal. Am J Sports Med, 2012, 40(2):332-338.
16.	Chen L, Linde-Rosen M, Hwang SC, et al. The effect of medial meniscal horn injury on knee stability. Knee Surg Sports Traumatol Arthrosc, 2015, 23(1):126-131.
17.	Lorbach O, Kieb M, Herbort M, et al. The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee. Int Orthop, 2015, 39(4):681-687.
18.	Morey VM, Nag HL, Chowdhury B, et al. Arthroscopic anatomic double bundle anterior cruciate ligament reconstruction:Our experience with follow-up of 4 years. J Clin Orthop Trauma, 2016, 7(1):17-22.

1. Henning CE. Current status of meniscus salvage. Clin Sports Med, 1990, 9(3):567-576.
2. Murawski CD, Wolf MR, Araki D, et al. Anatomic anterior cruciate ligament reconstruction:current concepts and future perspective. Cartilage, 2013, 4(3 Suppl):27S-37S.
3. Indelicato PA, Bittar ES. A perspective of lesions associated with ACL insufficiency of the knee. A review of 100 cases. Clin Orthop Relat Res, 1985, (198):77-80.
4. Rijke AM, Perrin DH, Goitz HT, et al. Instrumented arthrometry for diagnosing partial versus complete anterior cruciate ligament tears. Am J Sports Med, 1994, 22(2):294-298.
5. Marcacci M, Bonanzinga T, Grassi A, et al. Long-term clinical outcomes of combined BPTB ACL reconstruction and popliteus tendon plasty. Knee Surg Sports Traumatol Arthrosc, 2015, 23(10):2930-2935.
6. Kim SJ, Kim HK. Reliability of the anterior drawer test, the pivot shift test, and the Lachman test. Clin Orthop Relat Res, 1995, (317):237-242.
7. Mulligan EP, McGuffie DQ, Coyner K, et al. The reliability and diagnostic accuracy of assessing the translation endpoint during the lachman test. Int J Sports Phys Ther, 2015, 10(1):52-61.
8. Stanev D, Moustakas K, Gliatis J, et al. ACL reconstruction decision support. Personalized simulation of the Lachman test and custom activities. Methods Inf Med, 2016, 55(1):98-105.
9. Yaqoob J, Alam MS, Khalid N. Diagnostic accuracy of Magnetic Resonance Imaging in assessment of Meniscal and ACL tear:Correlation with arthroscopy. Pak J Med Sci, 2015, 31(2):263-268.
10. Murase Ki K, Takahei T, Obata H, et al. Anterior cruciate ligament reconstruction with a multistrand hamstring graft fixed with a Ligament Tension Screw:a new device that can be used to readjust graft tension after fixation. J Orthop Sci, 2002, 7(1):48-55.
11. Papastergiou SG, Koukoulias NE, Mikalef P, et al. Meniscal tears in the ACL-deficient knee:correlation between meniscal tears and the timing of ACL reconstruction. Knee Surg Sports Traumatol Arthrosc, 2007, 15(12):1438-1444.
12. Tandogan RN, Taşer O, Kayaalp A, et al. Analysis of meniscal and chondrallesions accompanying anterior cruciate ligament tears:relationshipwith age, time from injury, and level of sport. Knee Surg Sports Traumatol Arthrosc, 2004, 12(4):262-270.
13. Todor A, Nistor D, Buescu C, et al. Incidence and treatment of intra-articular lesions associated with anterior cruciate ligament tears. Clujul Med, 2014, 87(2):106-108.
14. Dürselen L, Vögele S, Seitz AM, et al. Anterior knee laxity increases gapping of posterior horn medial meniscal tears. Am J Sports Med, 2011, 39(8):1749-1755.
15. Markolf KL, Jackson SR, McAllister DR. Force measurements in the medial meniscus posterior horn attachment:effects of anterior cruciate ligament removal. Am J Sports Med, 2012, 40(2):332-338.
16. Chen L, Linde-Rosen M, Hwang SC, et al. The effect of medial meniscal horn injury on knee stability. Knee Surg Sports Traumatol Arthrosc, 2015, 23(1):126-131.
17. Lorbach O, Kieb M, Herbort M, et al. The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee. Int Orthop, 2015, 39(4):681-687.
18. Morey VM, Nag HL, Chowdhury B, et al. Arthroscopic anatomic double bundle anterior cruciate ligament reconstruction:Our experience with follow-up of 4 years. J Clin Orthop Trauma, 2016, 7(1):17-22.

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DIAGNOSTIC SIGNIFICANCE OF MEDIAL MENISCUS INJURY IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION FAILURE

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