O'Donoghue unhappy triad
Citation, DOI, disclosures and article data
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosuresAt the time the article was last revised Tariq Walizai had no financial relationships to ineligible companies to disclose.
View Tariq Walizai's current disclosures- O'Donoghue triad
- Unhappy triad
- O'Donoghue's triad
- Unhappy medial triad
O'Donoghue unhappy triad or terrible triad often occurs in contact and non-contact sports, such as basketball, football, or rugby, when there is a lateral force applied to the knee while the foot is fixated on the ground. This produces an abduction-external rotation mechanism of injury ("pivot shift" in non-contact sports).
Pathology
The O'Donoghue unhappy triad comprises three types of soft tissue injury that frequently tend to occur simultaneously in knee injuries. O'Donoghue described the injuries as:
The triad has subsequently been revisited considering the arthroscopic findings in patients with both ACL and MCL injuries, where a lateral meniscal injury is more common than injury to the medial meniscus 2. Mechanistically this makes more sense during the pivot shift movement, as the lateral tibiofemoral compartment is compressed, causing failure of the lateral meniscus.
History and etymology
The unhappy triad is named after D H O'Donoghue, American orthopedic surgeon, who described it in 1950 4.
Quiz questions
References
- 1. Sanders TG, Medynski MA, Feller JF et-al. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics. 2000;20 Spec No (suppl 1): S135-51. Radiographics (full text) - Pubmed citation
- 2. Shelbourne KD, Nitz PA. The O'Donoghue triad revisited. Combined knee injuries involving anterior cruciate and medial collateral ligament tears. Am J Sports Med. 1992;19 (5): 474-7. Pubmed citation
- 3. Barber FA. What is the terrible triad?. Arthroscopy. 1992;8 (1): 19-22. Pubmed citation
- 4. O'Donoghue D H. Surgical treatment of fresh injuries to the major ligaments of the knee. J Bone Joint Surg Am. 2004;32 (A:4): 721-38. Pubmed citation
- 5. William Palmer, Laura Bancroft, Fiona Bonar, Jung-Ah Choi, Anne Cotten, James F. Griffith, Philip Robinson, Christian W.A. Pfirrmann. Glossary of terms for musculoskeletal radiology. (2020) Skeletal Radiology. doi:10.1007/s00256-020-03465-1 - Pubmed
Incoming Links
- O'Donoghue unhappy triad
- O'Donoghue unhappy triad
- Pivot shift injury
- O'Donoghue unhappy triad
- Anterior cruciate ligament tear - O'Donoghue unhappy triad
- Isolated ACL injury
- Combined medial and lateral bucket handle meniscal tears
- Pivot shift injury - ACL, medial meniscus and MCL tears
- Pivot shift injury - ACL, medial meniscus and MCL tears
- O'Donoghue's unhappy triad
- O'Donoghue's unhappy triad
- Unhappy triad of the knee
- O'Donoghue's unhappy triad
Related articles: Knee pathology
The knee is a complex synovial joint that can be affected by a range of pathologies:
- bone and cartilage
-
knee fractures
- distal femoral condyle fracture
- tibial plateau fracture (classification)
- patella fracture
-
avulsion fractures of the knee
- arcuate complex avulsion fracture (arcuate sign)
- anterior cruciate ligament avulsion fracture
- biceps femoris avulsion fracture
- iliotibial band avulsion fracture
- quadriceps tendon avulsion fracture
- patellar sleeve fracture
- posterior cruciate ligament avulsion fracture
- reverse Segond fracture
- Segond fracture
- semimembranosus tendon avulsion fracture
- Stieda fracture chronic avulsion injuries
- dislocation
- chondromalacia patellae
- osteoarthritis of the knee
- osteochondral
- patterns of bone bruise in knee injury
-
knee fractures
- ligaments
- anterior cruciate ligament tear
- anterior cruciate ligament ganglion cyst
- anterior cruciate ligament mucoid degeneration
- posterior cruciate ligament tear
- medial collateral ligament tear
- lateral collateral ligament tear
- medial patellofemoral ligament tear
- posterolateral corner injury
- posteromedial corner injury
- tendons
- meniscal lesions
- bursosynovial lesions
- fat pad
- popliteal fossa
- fascia
- alignment
- knee
- patellofemoral
- gamut
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