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Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 May;35(5):556-561

Department of Knee Surgery, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang Henan, 471002, P.R.China.

Objective: To investigate the short-term effectiveness of arthroscopic single bundle four-strand reconstruction using autologous semitendinosus tendon and anterior half of peroneus longus tendon for posterior cruciate ligament (PCL) injuries.

Methods: A clinical data of 30 patients with PCL injury, who were admitted between December 2015 and September 2018 and met the selection criteria, was retrospectively analyzed. All patients were treated with arthroscopic single bundle four-strand reconstruction using autologous semitendinosus tendon and anterior half of peroneus longus tendon and TightRope technique. Read More

Orthop J Sports Med 2021 Apr 16;9(4):2325967121998310. Epub 2021 Apr 16.

Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Québec, Canada.

Background: The mechanism for traumatic ruptures of the native anterior cruciate ligament (ACL) is frequently a noncontact injury involving a valgus moment with internal rotation of the tibia. The abnormal rotation and translation of the lateral femoral condyle posteroinferiorly relative to the lateral tibial plateau is thought to be related to the geometry of the tibial plateau.

Purpose/hypothesis: The purpose of the study was to mathematically model the posterior tibial plateau geometry in patients with ACL injuries and compare it with that of matched controls. Read More

J Knee Surg 2021 Apr 30. Epub 2021 Apr 30.

Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago, Chicago, Illinois.

The purpose of this study was to define the diagnostic value of magnetic resonance imaging (MRI) and plain radiographs (X-ray [XR]) in identifying an osteochondral defect or loose body in patients undergoing operative treatment for patellar instability. A total of 87 patients treated operatively for patellar instability with medial patellofemoral ligament (MPFL) reconstruction between 2015 and 2019 were identified. Inclusion criteria were evidence of clinical patellar instability, preoperative XR and MRI studies, and concomitant diagnostic knee arthroscopy and MPFL reconstruction performed to address patellar instability. Read More

Am J Sports Med 2021 Jun 30;49(7):1822-1826. Epub 2021 Apr 30.

Department of Orthopaedics, Children's Hospital, CHU de Toulouse, Toulouse, France.

Background: Anterior cruciate ligament (ACL) tears represent 13% of knee injuries in children. Medial meniscal tears are commonly associated with ACL ruptures. Ramp lesions correspond to posterior meniscocapsular tears of the medial meniscus. Read More

Arthroscopy 2021 05;37(5):1378-1380

Twin Cities Orthopedics, Edina-Crosstown. Edina, Minnesota, U.S.A.. Electronic address:

Patients with multiligament knee injuries require a thorough examination (Lachman, posterior-drawer, varus, valgus, and rotational testing). Diagnoses are confirmed with magnetic resonance imaging as well as stress radiographs (posterior, varus, and valgus) when indicated. Multiple systematic reviews have reported that early (<3 weeks after injury) single-stage surgery and early knee motion improves patient-reported outcomes. Read More

Am J Sports Med 2021 05 16;49(6):1470-1481. Epub 2021 Apr 16.

Department of Rehabilitation Sciences, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium.

Background: Rates of reinjury, return to play (RTP) at the preinjury level, and hamstring strain injuries in male soccer players after anterior cruciate ligament reconstruction (ACLR) remain unsatisfactory, due to multifactorial causes. Recent insights on intramuscular hamstring coordination revealed the semitendinosus (ST) to be of crucial importance for hamstring functioning, especially during heavy eccentric hamstring loading. Scientific evidence on the consequences of ST tendon harvest for ACLR is scarce and inconsistent. Read More

Orthop J Sports Med 2021 Mar 17;9(3):2325967121989678. Epub 2021 Mar 17.

Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China.

Background: Clinical outcomes of surgical repairs for tears of the lateral meniscus posterior root (LMPR) in patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) have not been comprehensively investigated.

Purpose: To systematically review the clinical, radiographic, and arthroscopic results of surgical repairs for tears of the LMPR in patients undergoing ACLR.

Study Design: Systematic review; Level of evidence, 4. Read More

Orthop J Sports Med 2021 Feb 22;9(2):2325967120973195. Epub 2021 Feb 22.

Twin Cities Orthopedics, Edina, Minnesota, USA.

Background: The posterior meniscofemoral ligament (pMFL) of Wrisberg attaches to the posterior horn of the lateral meniscus and the lateral intercondylar aspect of the medial femoral condyle and passes posteriorly to the posterior cruciate ligament (PCL). The pMFL plays a role in recovery after PCL injuries and offers stability to the lateral meniscus, promoting normal knee function.

Purpose/hypothesis: The aim of the magnetic resonance imaging (MRI) arm of this study was to evaluate the prevalence of the pMFL in Polish patients. Read More

Orthop J Sports Med 2021 Feb 22;9(2):2325967120973192. Epub 2021 Feb 22.

Twin Cities Orthopedics, Edina, Minnesota, USA.

Background: The anterior meniscofemoral ligament (aMFL) of Humphrey is an anatomically variable fibrous band of connective tissue that attaches between the lateral aspect of the medial femoral condyle and posterior horn of the lateral meniscus, running posterior to the anterior cruciate ligament and anterior to the posterior cruciate ligament (PCL). The presence of an intact aMFL may contribute to stabilization of the lateral compartment of the knee joint.

Purpose: The original magnetic resonance imaging (MRI) arm of this study aimed to assess the aMFL incidence among Polish patients. Read More

Open Access J Sports Med 2021 8;12:23-32. Epub 2021 Mar 8.

Department of Radiology, Boston University School of Medicine, Boston, MA, USA.

Purpose: Describe the frequency and severity of knee ligament sprains diagnosed by MRI in athletes participating at the 2016 Summer Olympic Games, their association with certain sports and assess correlations with additional knee structural injury.

Patients And Methods: All knee MRIs performed in the Olympic Village and polyclinics during the 2016 Olympics were retrospectively, blindly reviewed for ligament sprains and associated knee injuries. In addition to the absence or presence of these abnormalities, athletes were stratified by age, gender and sport. Read More

Am J Sports Med 2021 04 8;49(5):1244-1250. Epub 2021 Mar 8.

Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway.

Background: Increased lateral posterior tibial slope (LPTS) is associated with increased rates of anterior cruciate ligament (ACL) injury and failure of ACL reconstruction. It is unknown if ACL deficiency influences the developing proximal tibial physis and slope in skeletally immature patients through anterior tibial subluxation and abnormal force transmission.

Purpose: To assess the natural history of LPTS in skeletally immature patients with an ACL-injured knee. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Mar 4. Epub 2021 Mar 4.

Fortius Clinic, 17 Fitzhardinge St, London, W1H 6EQ, UK.

Purpose: In anterior cruciate ligament (ACL) injuries, concomitant damage to peripheral soft tissues is associated with increased rotatory instability of the knee. The purpose of this study was to investigate the incidence and patterns of medial collateral ligament complex injuries in patients with clinically 'isolated' ACL ruptures.

Methods: Patients who underwent ACL reconstruction for complete 'presumed isolated' ACL rupture between 2015 and 2019 were retrospectively included in this study. Read More

J Knee Surg 2021 Apr 22;34(5):493-498. Epub 2021 Feb 22.

Department of Radiology, Musculoskeletal Imaging, University of Missouri, Columbia, Missouri.

Posterior cruciate ligament (PCL) injuries can often be missed on physical examination, especially in multiligament knee injuries. Therefore, a comprehensive approach to imaging the PCL should be implemented whenever history and examination findings indicate relative risk. Radiography, including a posterior-stress view, and magnetic resonance imaging, when available, provide consistently accurate diagnosis of PCL pathology and common knee comorbidities. Read More

Am J Sports Med 2021 03 22;49(4):928-934. Epub 2021 Feb 22.

Division of Orthopaedic Surgery, Rady Children's Hospital, San Diego, California, USA.

Background: Incompetence of the anterior cruciate ligament (ACL) confers knee laxity in the sagittal and axial planes that is measurable with clinical examination and diagnostic imaging.

Hypothesis: An ACL-deficient knee will produce a more vertical orientation of the lateral collateral ligament (LCL), allowing for the entire length of the LCL to be visualized on a single coronal slice (coronal LCL sign) on magnetic resonance imaging.

Study Design: Cohort study (diagnosis); Level of evidence, 3. Read More

Am J Sports Med 2021 03 22;49(4):935-940. Epub 2021 Feb 22.

Division of Orthopaedic Surgery, Rady Children's Hospital, San Diego, California, USA.

Background: The coronal lateral collateral ligament (LCL) sign is the presence of the full length of the LCL visualized on a single coronal magnetic resonance imaging (MRI) slice at the posterolateral corner of the knee. The coronal LCL sign has been shown to be associated with elevated measures of anterior tibial translation and internal rotation in the setting of anterior cruciate ligament (ACL) tear.

Hypothesis: The coronal LCL sign (with greater anterior translation, internal rotation, and posterior slope of the tibia) will indicate a greater risk for graft failure after ACL reconstructive surgery. Read More

Am J Sports Med 2021 03 17;49(4):970-974. Epub 2021 Feb 17.

Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.

Background: Tibial tubercle-trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning.

Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG.

Study Design: Cross-sectional study; Level of evidence, 3. Read More

Emerg Radiol 2021 Feb 10. Epub 2021 Feb 10.

E.B. Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin Street, Suite 470, Houston, TX, 77030-2399, USA.

Purpose: To describe the first "arcuate sign" case series in the pediatric population, radiologic features of the associated injuries, management, and how they compare with the adult population.

Methods: Retrospective study included patients under 18 years of age with a classic "arcuate sign" on radiographs. Data collected included patient demographics, mechanism of injury, and management. Read More

Surg Radiol Anat 2021 Feb 9. Epub 2021 Feb 9.

Faculty of Health Sciences, Department of Anatomy, School of Medicine, University of Pretoria, Pretoria, South Africa.

Purpose: The purpose of this study was to quantify the posterior horn meniscal slope and determine its contribution to the reduction in posterior tibial slope.

Methods: Patients aged between 16 and 60 years and had intact menisci with no evidence of previous injury or surgery were included. Patients with radiological evidence of osteoarthritis Grade II-IV, any acute or chronic meniscus injuries, fractures, and ligamentous injuries were excluded. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Feb 9. Epub 2021 Feb 9.

New York University Langone Orthopedic Hospital, 333 East 38th Street, New York, NY, 10016, USA.

Purpose: The purpose of this study was to identify if the location of posterolateral corner (PLC) injury was predictive of clinical common peroneal nerve (CPN) palsy.

Methods: A retrospective chart review was conducted of patients presenting to our institution with operative PLC injuries. Assessment of concomitant injuries and presence of neurologic injury was completed via chart review and magnetic resonance imaging (MRI) review. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Feb 1. Epub 2021 Feb 1.

Twin Cities Orthopedics, 4010 West 65th Street, Edina, MN, 55435, USA.

Purpose: While the association with acute anterior cruciate ligament (ACL) tears has been established, other risk factors and associated pathologies which occur with a concomitant lateral meniscal posterior root tear (LMPRT) are not well defined. The purpose of this study was to compare the risk factors and concomitant pathologies between patients with LMPRT and patients without LMPRTs in the setting of a primary ACL tear.

Methods: Patients with a LMPRT identified at the time of primary ACL reconstruction by a single surgeon were identified. Read More

BMC Musculoskelet Disord 2021 Jan 29;22(1):124. Epub 2021 Jan 29.

Department of Orthopedic Surgery, Meir General Hospital, Kfar Saba, and Sackler Faculty of Medicine, Tel Aviv University, Tsharnichovski street 59, 44281, Kfar Saba, Israel.

Background: MRI is the most accurate imaging modality for diagnosing knee pathologies. However, there is uncertainty concerning factors predicting false negative MRI, such as meniscal tear patterns as well as patient factors. The aims of this study were to report 1. Read More

Ann Transl Med 2020 Dec;8(24):1657

Department of Gynaecology, Shijiazhuang Third Hospital, Shijiazhuang, China.

Background: Anterior cruciate ligament (ACL) injury can cause damage to the meniscus and articular cartilage, and may even lead to osteoarthritis. This study aimed to analyze the accuracy and feasibility of magnetic resonance imaging (MRI) imaging signs in the diagnosis of knee joint ACL injury.

Methods: A total of 78 patients admitted to our hospital from June 2018 to October 2019 with highly suspected ACL injury were selected for this prospective study. Read More

BMC Musculoskelet Disord 2021 Jan 21;22(1):100. Epub 2021 Jan 21.

Department of Orthopedics, Beijing Shunyi District Hospital, Beijing, China.

Background: Several studies on the relationship between morphological parameters and traumatic diseases of the knee have already been conducted. However, few studies focused on the association between knee morphology and posterior cruciate ligament (PCL) avulsion fracture in adults. The objective of this study was to evaluate the impact of knee morphology on PCL avulsion fracture. Read More

Arthroscopy 2021 05 13;37(5):1599-1609. Epub 2021 Jan 13.

MSk Lab, Imperial College London, Sir Michael Uren Biomedical Engineering Research Hub, London, United Kingdom.

Purpose: To examine the relationship between posterior tibial slope and lateral meniscal bone angle (LMBA) on anterior cruciate ligament (ACL) tear risk in a pediatric population.

Methods: In this case-control study, non-contact ACL-injured pediatric patients with no significant lateral meniscal lesions were matched by age and sex in a 1:1 ratio to a group of radiologically normal controls. Knee magnetic resonance imaging (MRI) studies were analyzed by 3 independent, blinded observers measuring the medial posterior tibial slope (MTS), lateral posterior tibial slope (LTS), and LMBA. Read More

Am J Sports Med 2021 03 15;49(3):684-692. Epub 2021 Jan 15.

Department of Sports Orthopaedics, Hoshigaoka Medical Center, Hirakata, Osaka, Japan.

Background: Meniscal function after repair of longitudinal tears of the lateral meniscus (LM) with anterior cruciate ligament reconstruction (ACLR) has not been comprehensively investigated.

Purpose: To evaluate not only the clinical outcomes and radiographic findings of patients who underwent repair of longitudinal tears of the LM combined with ACLR but also the healing status of the repaired meniscus and changes in chondral status with second-look arthroscopy.

Study Design: Case series; Level of evidence, 4. Read More

BMC Musculoskelet Disord 2021 Jan 8;22(1):52. Epub 2021 Jan 8.

Department of Orthopaedic Surgery, West China Hospital, Sichuan University, 37 Guoxue lane, Wuhou District, Chengdu, China.

Background: The radiological indicators can help doctors determine whether to make tibial tubercle transfer. But which indicator is better is still in question.

Methods: 117 knees in 103 patients who had undergone patellar surgery and 60 knees in 58 patients who had no history of patellar dislocation from 2014 to 2019 were analyzed. Read More

Arthroscopy 2021 01;37(1):15-16

Norwegian School of Sports Sciences, Oslo Sports Trauma Research Center, Oslo, Norway; University of Oslo, Ulleval Hospital, Oslo, Norway.

Stress radiographs can provide an objective, quantifiable assessment of ligamentous knee injury. Commonly utilized techniques include varus, valgus, and posterior stress radiographs and can be used to augment findings on physical examination and magnetic resonance imaging. Both in vitro and in vivo studies have demonstrated reliability and validity of stress radiographs for diagnosing isolated and multiple ligament knee injuries. Read More

Am J Sports Med 2021 02 31;49(2):450-458. Epub 2020 Dec 31.

Rehabilitation Hospital affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China.

Background: Little data exist in the literature regarding second-look arthroscopic outcomes after pullout repair for avulsion tears of the posterior lateral meniscus root.

Purpose: To (1) assess the functional, magnetic resonance imaging (MRI), and second-look arthroscopic outcomes after pullout repair for avulsion tears of the posterior lateral meniscus root; (2) determine which demographic and clinical factors influenced healing of the repaired posterior lateral meniscus root; and (3) compare outcomes between different meniscal healing status groups.

Study Design: Case series; Level of evidence, 4. Read More

Radiologe 2021 Feb 21;61(2):203-212. Epub 2020 Dec 21.

Radiologisches Zentrum für Diagnostik und Therapie München, Oberföhringer Straße 2, 81679, München, Deutschland.

Backround: SPACE (3D fast spin echo acquisition) sequences require long scan times for three-dimensional assessment of acute injury of the knee joint and are flawed due to geometric blurring. Their implementation into routine diagnostic imaging was not feasible until recently.

Objectives: By comparing conventional MRI (magnetic resonance imaging) sequences to 3D (three-dimensional) sequences, it was investigated whether the compressed sensing (CS) technique is inferior to the established 2D sequences with shorter examination times. Read More

BMC Musculoskelet Disord 2020 Dec 18;21(1):844. Epub 2020 Dec 18.

Department of Orthopaedic and Trauma Surgery, Center for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.

Purpose: Reconstruction of the Anterior cruciate ligament (ACL) using tendon grafting is an established method for restoring knee function and stability. Multiple methods are established for graft fixation. Several involve anchoring the autograft distant to the joint with hardware that remains implanted. Read More