Anterior cruciate ligament graft tear and bucket-handle tear of medial meniscus

Case contributed by Magdalena Chmiel-Nowak


Twisting injury two weeks ago. History of prior ACL reconstruction two years ago.

Patient Data

Age: 35 years
Gender: Male

Joint effusion. 

Discontinuity of the ACL graft, in keeping with its rupture. Anterior tibial translation.

Bone bruises in locations typical for a pivot-shift injury. Impaction fracture at the terminal sulcus of LFC.

Incomplete longitudinal tear of the body and posterior horn of the medial meniscus. Associated bone bruises in peripheral parts of MFC and MTC.

Baker's cyst.

Follow-up study 5 weeks later - new twisting injury one week ago


Joint effusion.

Partial regression of bone bruises, which now makes a subchondral fracture line appreciable at the site of impaction injury of LFC.

Progression of previous medial meniscal tear into a bucket-handle tear.

Complete tear of the ACL graft - as previously seen.

Baker's cyst.

Case Discussion

The patient experienced another twisting injury four weeks after the initial examination and had a second MR study, which showed progression of an incomplete longitudinal meniscal tear into a bucket-handle tear. This shows possible consequences of a longitudinal meniscal tear, especially in the setting of unstable joint (due to ACL graft rupture) and repeated trauma.

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