Full-thickness ACL tear

Case contributed by Ryan Thibodeau
Diagnosis certain

Presentation

Persistent pain following twisting knee injury while skiing.

Patient Data

Age: 30 years
Gender: Male
mri

The ACL is edematous and laxed with complete disruption of the proximal fibers compatible with acute full-thickness tear. Distal anterior fibers are retracted and flipped into the anterior intercondylar notch. The medial and lateral menisci are intact.

The LCL complex is intact with normal thickness and signal intensity. However, there is moderate-severe peri-ligamentous soft tissue edema.

There are focal subchondral fractures of the lateral femoral condyle and posterior aspect of the lateral tibial plateau with associated moderate bone marrow edema. Additional severe marrow edema and possible small cortical avulsion fracture of medial tibial eminence. There is a moderate joint effusion.

Case Discussion

This is an acute full thickness tear of the anterior cruciate ligament (ACL). The patient was subsequently scheduled to see an orthopedic surgeon for operative repair.

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