Citation, DOI, disclosures and article data
Citation:
Roberts D, Bell D, Feger J, Anterior interval lesion. Reference article, Radiopaedia.org (Accessed on 28 Mar 2024) https://doi.org/10.53347/rID-88341
An anterior interval lesion is an area of localized arthrofibrosis of the anterior interval, which can occur after ACL reconstruction.
The anterior interval of the knee is found posterior to Hoffa’s fat pad, between the inferior and posterior patella and the anterosuperior tibial plateau 1. Arthrofibrosis can occur after ACL reconstruction, which can be localized in the form of cyclops lesions and/or anterior interval lesions. Different terminology is used in the literature when referring to anterior interval lesions, and these include intrapatellar fat pad fibrosis 2.
Post ACL reconstruction, patients can present with a lack of knee extension, new patella baja 3, and/or a mechanical endpoint in knee movements.
The ACL reconstruction should be assessed for possible areas of arthrofibrosis and MRI is the investigation of choice to assess for arthrofibrosis and intra-articular pathology of the knee.
Plain radiograph
Most often will not be identifiable. May show new patella baja.
CT
Best appreciated on soft tissue windows, nodular soft tissue density thickening of the anterior interval.
MRI
The anterior interval will be thickened and nodular.
T1: low signal intensity
T2: low signal intensity
Treatment and prognosis
Arthroscopic release has been described 4, 5.
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1. Kim D, Kim GT, Kim MP, Kim. Arthroscopic treatment of the arthrofibrotic knee. (2004) Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. doi:10.1016/j.arthro.2004.04.036 - Pubmed
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2. Dragoo J, Dragoo JC, Dragoo MJ, Dragoo. Evaluation and treatment of disorders of the infrapatellar fat pad. (2012) Sports medicine (Auckland, N.Z.). doi:10.2165/11595680-000000000-00000 - Pubmed
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3 . Mitchell I. Kennedy, Zach Aman, Nicholas N. DePhillipo, Robert F. LaPrade. Patellar Tendon Tenotomy for Treatment of Patella Baja and Extension Deficiency (2019).
Arthroscopy Techniques,Volume 8, Issue 3, Pages e317-e320. ISSN 2212-6287,
https://doi.org/10.1016/j.eats.2018.11.010.
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4. Rose M, McNeilan R, Genuario J, Schlegel T. Surgical Technique for Release of Anterior Interval Scarring of the Knee After Anterior Cruciate Ligament Reconstruction. (2018) Arthroscopy techniques. 7 (9): e887-e891. doi:10.1016/j.eats.2018.04.016 - Pubmed
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5. Steadman J, Steadman DJ, Steadman HS, Steadman BK, Steadman. Arthroscopic release for symptomatic scarring of the anterior interval of the knee. (2008) The American journal of sports medicine. doi:10.1177/0363546508320480 - Pubmed
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