Complete ACL tear with important associated injuries

Case contributed by Dr Andrew Dixon

Presentation

Acute knee injury. ?ACL tear

Patient Data

Age: 25 years
Gender: Male

 

  1. Complete ACL tear with anterior tibial translation.
  2. Impaction contusions of the lateral femoral sulcus and posterior tibial plateau. 
  3. High-grade posterolateral corner injury including arcuate ligament complex injury, popliteus tendon strain, soleus tendon and biceps femoris fibular avulsions. High-grade lateral and anterolateral capsular injury with Segond fracture
  4. High grade tear of the medial collateral ligament with the meniscotibial attachment remaining intact.
  5. Discontinuous bucket handle tear of the medial meniscus.
  6. Lateral meniscal tears including an outer fragment of the meniscal body flipped into the tibial recess.
  7. 7 mm region of posterior tibial delaminated cartilage underlying the posterior horn of the lateral meniscus. 

Case Discussion

This MRI case demonstrates many of the important injuries seen in association with complete ACL tear including;

  1. ACL instability - anterior tibial translation.
  2. Impaction contusions of the lateral femoral sulcus and posterior tibial plateau. 
  3. High-grade posterolateral corner injury including arcuate ligament complex injury, popliteus tendon strain, soleus tendon and biceps femoris fibular avulsions. High-grade lateral and anterolateral capsular injury with Segond fracture
  4. High grade tear of the medial collateral ligament with the meniscotibial attachment remaining intact.
  5. Discontinuous bucket handle tear of the medial meniscus.
  6. Lateral meniscal tears including an outer fragment of the meniscal body flipped into the tibial recess.
  7. 7 mm region of posterior tibial delaminated cartilage underlying the posterior horn of the lateral meniscus. 
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Case information

rID: 22334
Case created: 27th Mar 2013
Last edited: 24th May 2016
Tags: knee, mri, acl
Inclusion in quiz mode: Included

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