Chronic anterior cruciate ligament tear and displaced flap tear of the medial meniscus
Presentation
Knee trauma
Patient Data
The medial meniscus's absent posterior horn on the sagittal with meniscal fragments are visible in the intercondylar notch and medial inferior parameniscal recesses in keeping with displaced flap tear.
Truncated body and posterior horn of the lateral meniscus on the coronal consistently with a radial tear.
Odeme surrounds the medial collateral ligament compatible with MCL tear.
Anterior tibial translation, the anterior cruciate ligament is absent, and depression at the tibial plateau insertion site but only slightly edema marrow suggests a chronic ACL tear.
Knee joint effusion
The cystic bone locates in the distal femur.
Red arrows: A meniscal fragment lying in the intercondylar notch, around the PCL.
Case Discussion
Chronic ACL tears cause instability leading to a secondary meniscal tear. Acute ACL tears are associated with lateral meniscal tears, while chronic ACL tears are associated with medial meniscal tears 1.
Displaced tears consist of free fragments, displaced flap tears, and bucket-handle tears 2. The meniscal fragments can be missed at arthroscopy, which often cause persistent pain and locking of the knee. Therefore, it is crucial to identify them before surgery.
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