Anterior Cruciate Ligament Injury Research Articles

Posterior tibial slope angle in contact versus non-contact anterior cruciate ligament injuries.

Increased Posterior Tibial Slope (PTS) angle has been reported to be a risk factor for primary anterior cruciate ligament (ACL) tears. However, it is unknown whether increased PTS has an associated increased risk for non-contact versus contact ACL injury. The purpose of this study is to determine whether patients with non-contact ACL injury have a higher PTS angle than those with contact ACL injury. A total of 1700 patients who underwent primary ACL reconstruction between January 2011 and June 2023 at a single academic institution were initially included. Electronic medical records were reviewed for demographic information as well as evidence that the patient sustained a contact or non-contact ACL injury. Patients in the contact cohort were propensity score matched to patients in the non-contact cohort by age, sex and BMI. Additionally, patients in the contact cohort were then propensity score matched to a control group of patients with intact ACLs also by age, sex and BMI. One hundred and two patients with contact injury were initially identified and 1598 patients with non-contact injuries were identified. Of the 102, 67 had knee X-rays that were suitable for measurement. These 67 contact injury patients were propensity score matched to 67 noncontact patient and 67 patients with intact ACLs based on age, sex and BMI. There were no significant differences between contact and non-contact cohorts in age (28.7±6.3 vs. 27.1±6.5, p = 0.147), sex (Female: 36.0% vs. 34.3%, p = 0.858), or BMI (26.7±5.6 vs 26.1±3.4, p= 0.475). There was no significant difference in PTS angle between contact versus non-contact ACL injury patients (11.6±3.0 vs.11.6±2.8, p= 0.894). There was a significant difference in PTS between the contact ACL injury and the intact cohort (11.6±3.0 vs. 10.0±3.9, p= 0.010) and the non-contact ACL injury and the intact cohort (11.6±2.8 vs. 10.0±3.9, p = 0.010). There was no significant difference in the degree of PTS between patients who sustained contact versus non-contact ACL injuries. Additionally, there was a significantly increased PTS in both the contact and non-contact ACL injury cohorts compared to patients with intact ACLs.

A Robotic Clamped-Kinematic System to Study Knee Ligament Injury.

Knee ligament injury is among the most common sports injuries and is associated with long recovery periods and low return-to-sport rates. Unfortunately, the mechanics of ligament injury are difficult to study in vivo, and computational studies provide limited insight. The objective of this study was to implement and validate a robotic system capable of reproducing natural six degree-of-freedom clamped-kinematic trajectories on human cadaver knees (meaning that positions and orientations are rigidly controlled and resultant loads are measured). To accomplish this, we leveraged the field's recent access to high-fidelity bone kinematics from dynamic biplanar radiography (DBR), and implemented these kinematics in a coordinate frame built around the knee's natural flexion-extension axis. We assessed our system's capabilities in the context of ACL injury, by moving seven cadaveric knee specimens through kinematics derived from walking, running, drop jump, and ACL injury. We then used robotically simulated clinical stability tests to evaluate the hypothesis that knee stability would be only reduced by the motions intended to injure the knee. Our results show that the structural integrity of the knee was not compromised by non-injurious motions, while the injury motion produced a clinically relevant ACL injury with characteristic anterior and valgus instability. We also demonstrated that our robotic system can provide direct measurements of reaction loads during a variety of motions, and facilitate gross evaluation of ligament failure mechanisms. Clamped-kinematic robotic evaluation of cadaver knees has the potential to deepen understanding of the mechanics of knee ligament injury.

Primary ACL repair in a selected patient cohort: A prospective single cohort study

BackgroundAnterior cruciate ligament (ACL) tears are common knee injuries, particularly in physically active individuals. While ACL reconstruction (ACL-R) is the standard treatment, it has notable limitations. Recent interest in primary ACL repair offers a potential alternative, especially for specific tear types and patient demographics. PurposeTo evaluate the outcomes of primary ACL repair in a selected patient cohort with strict inclusion and exclusion criteria, focusing on the survival of the procedure, functional outcomes, and factors influencing success rates. MethodsThis prospective single cohort study included 61 patients who underwent primary ACL repair between June 2016 and June 2022. Patients were 50 years or younger, with recent ACL injuries and no previous knee surgeries or multiligament injuries. The primary outcomes were the survival of the repair beyond two years, measured by revision rates, and functional outcomes assessed using the Lysholm knee score, Tegner activity scale, and Lachmeter stability measurements. ResultsFifty-four patients completed a minimum follow-up of three years (average 49.6 months). The overall success rate was 82.2 %, with Sherman type 1 tears showing significantly fewer failures compared to type 2 (4.3 % vs. 31.8 %). The mean Lysholm score for successful repairs was 96, and the Tegner score dropped from a pre-injury average of 6 to 5. Adolescents had the highest failure rate (50 %), while other age groups showed better outcomes. The mean side-to-side difference in stability was 1.4 mm, favoring the control side. ConclusionPrimary ACL repair is a viable option for selected patients, particularly those with Sherman type 1 tears. While age and tear type significantly affect outcomes, the procedure shows promising results with high functional scores in successful repairs. Further research with larger cohorts and extended follow-ups is necessary to validate these findings and refine patient selection criteria. Primary ACL repair offers a less invasive alternative to ACL reconstruction, with potential for comparable outcome.

Effect of older age and/or ACL injury on the dose–response relationship between ambulatory load magnitude and immediate load-induced change in serum cartilage oligomeric matrix protein

PurposeThis study aimed to assess the influence of older vs. younger age and previous anterior cruciate ligament (ACL) injury on resting serum cartilage oligomeric matrix protein (sCOMP[tpre]) concentration, on immediate load-induced sCOMP kinetics after a 30-min treadmill walking stress (∆_sCOMP[tpost]), and on the dose–response relationship between ambulatory load magnitude and ∆_sCOMP(tpost). MethodsA total of 85 participants were recruited in 4 groups (20–30 years: 24 healthy, 23 ACL-injured; 40–60 years: 23 healthy, 15 ACL-injured). Blood samples were collected immediately before and after a walking stress at 80%, 100%, or 120% bodyweight (BW) on 3 test days and analyzed for sCOMP concentration. Linear models were used to estimate the effect of age, knee status (unilateral ACL injury, 2–10 years prior), and sex on sCOMP(tpre), ∆_sCOMP(tpost)), and the dose–response between ambulatory load magnitude and ∆_sCOMP(tpost). ResultsWe found that sCOMP(tpre) was 21% higher in older than younger participants (p < 0.001) but did not differ between ACL-injured and healthy participants (p = 0.632). Also, ∆_sCOMP(tpost) was 19% lower in older than younger participants (p = 0.030) and increased with body mass index (p < 0.001), sCOMP(tpre) (p = 0.008), and with 120%BW (p < 0.001), independent of age, ACL injury, or sex. ConclusionAge but not prior ACL injury influences resting sCOMP and load-induced sCOMP. The dose–response relationship between ambulatory load magnitude and load-induced sCOMP changes is not affected by age, ACL injury, or sex. A better understanding of systemic sCOMP and the role of its mechanoresponse for the understanding of osteoarthritis pathophysiology and monitoring intervention efficacy may require knowledge of individual cartilage composition and tissue-level loading parameters.

Preliminary identification of somatic mutations profile in ACL injury

Anterior cruciate ligament (ACL) injury is a common orthopedic disease with a high incidence, long recovery time, and often requiring surgical treatment. However, the susceptibility factors for ACL injury are currently unclear, and there is a lack of analysis on the differences in the ligament itself. Previous studies have focused on germline mutations, with less research on somatic mutations. To determine the role of somatic mutations in ACL injuries, we recruited seven patients between the ages of 20 and 39 years diagnosed with ACL injuries, collected their peripheral blood, injured ligament ends, and healthy ligament ends tissues, and performed exome sequencing with gene function enrichment analysis. We detected multiple gene mutations and gene deletions, which were only present in some of the samples. Unfortunately, it was not possible to determine whether these somatic mutations are related to ligament structure or function, or are involved in ACL injury. However, this study provides valuable clues for future in-depth research.

The gender and sex data gap in anterior cruciate ligament injuries in paediatric patients.

Anterior cruciate ligament (ACL) injury is a concerning problem in the paediatric population, impacting joint health and longevity. Moreover, ACL injury hampers physical activity, which is important for children's social network and general well-being. Recent data demonstrates a rise in paediatric ACL reconstructions, affecting both girls and boys. However, it is unclear whether this rise reflects a higher injury rate or a more proactive approach towards surgery, as information on nonoperated patients is lacking. Regarding gender differences, increasing evidence implies that girls engaged in pivoting sports experience a higher incidence of ACL injuries and reinjuries compared to boys. Furthermore, data suggestthat girls have inferior outcomes and lower return-to-sport rates than boys. The social context in which girls compete in sports is likely a significant contributing factor to the risk of serious knee injuries. Lack of attention and insufficient data on gender-based differences in ACL injuries, outcomesand evidence-based treatment guidelines highlight the need for further research on this topic. LEVEL OF EVIDENCE: Level IV.

The Role of Biomarkers in Predicting Outcomes of Anterior Cruciate Ligament Reconstruction: A Systematic Review.

Anterior cruciate ligament (ACL) injury is frequently associated with injuries to other parts of the knee, including the menisci and articular cartilage. After ACL injury and reconstruction, there may be progressive chondral degradation. Biomarkers in blood, urine, and synovial fluid can be measured after ACL injury and reconstruction and have been proposed as a means of measuring the associated cellular changes occurring in the knee. To systematically review the literature regarding biomarkers in urine, serum, or synovial fluid that have been associated with an outcome measure after ACL reconstruction. Systematic review; Level of evidence, 3. This review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The MEDLINE, Embase, CINAHL, and Web of Science databases were searched to identify studies published before September 2023 that reported on patients undergoing ACL reconstruction where a biomarker was measured and related to an outcome variable. Of 9360 results, 16 studies comprising 492 patients were included. Findings were reported as descriptive summaries synthesizing the available literature. A total of 45 unique biomarkers or biomarker ratios were investigated (12 serum, 3 urine, and 38 synovial fluid; 8 biomarkers were measured from >1 source). Nineteen different outcome measures were identified, including the International Knee Documentation Committee Subjective Knee Form, Knee injury and Osteoarthritis Outcome Score, numeric pain scores, radiological outcomes (magnetic resonance imaging and radiography), rates of arthrofibrosis and cyclops lesions, and gait biomechanics. Across the included studies, 17 biomarkers were found to have a statistically significant association (P < .05) with an outcome variable. Serum interleukin 6 (s-IL-6), serum and synovial fluid matrix metalloproteinase-3 (s-MMP-3 and sf-MMP-3), urinary and synovial fluid C-terminal telopeptide of type 2 collagen (u-CTX-II and sf-CTX-II), and serum collagen type 2 cleavage product (s-C2C) showed promise in predicting outcomes after ACL reconstruction, specifically regarding patient-reported outcome measures (s-IL-6 and u-CTX-II), gait biomechanical parameters (s-IL-6, sf-MMP-3, s-MMP-3, and s-C2C), pain (s-IL-6 and u-CTX-II), and radiological osteoarthritis (ratio of u-CTX-II to serum procollagen 2 C-propeptide). The results highlight several biomarkers that have been associated with clinically important postoperative outcome measures and may warrant further research to understand if they can provide meaningful information in the clinical environment.

Reliability of the Lever Sign Test in the Diagnosis of Anterior Cruciate Ligament Injuries: A Cross-Sectional Study with Interobserver Analysis

Introduction: Anterior cruciate ligament (ACL) injuries are known to have a high rate of occurrence among athletes. The growing prevalence of these injuries demands research in this field to determine clinically reliable diagnostic techniques. Aims: The goal of this study was to compare the diagnostic accuracy of the lever sign test with other frequently used manual tests, such as the anterior drawer and Lachman test, and to evaluate the sensitivity and specificity of the lever sign test in the diagnosis of ACL injuries. Study Design: The study was conducted for a period of 1 year, from November 2021 to November 2022, among 100 patients presenting to orthopedic outpatient department in a tertiary care center with complaints of acute knee pain after a trauma to the knee. Materials and Methods: A thorough history, physical examination, and three manual tests for diagnosing an ACL tear were performed by an intern, orthopedic resident, and consultant after obtaining consent. Arthroscopy of the injured knee was taken as the reference standard. Results: Of 100 patients, 53 were surgical and 67 were nonsurgical; the mean patient age was 33 years (range, 16 + 6.38 years). The overall accuracy of the lever sign test was 83% (85% sensitivity and 81% specificity); the accuracy was almost similar at arrival and under anesthesia (at arrival 86%, under anesthesia 80%), when performed by interns, postgraduates, and consultants. Conclusion: The lever sign test is easier to perform, equally efficacious, and reliable in diagnosing ACL injuries when compared to the other conventionally used manual tests.

Knee joint pathology and efferent pathway dysfunction: Mapping muscle inhibition from motor cortex to muscle force

BackgroundDysfunction in efferent pathways after knee pathology is tied to long-term impairments in quadriceps and hamstrings muscle performance, daily function, and health-related quality of life. Understanding the underlying etiology is crucial for effective treatment and prevention of poor outcomes, such as post-traumatic osteoarthritis or joint replacement. ObjectivesTo synthesize recent evidence of efferent pathway dysfunction (i.e., motor cortex, motor units) among individuals with knee pathology. DesignCommentary. MethodWe summarize the current literature investigating the motor cortex, corticospinal tract, and motoneuron pool in individuals with three common knee pathologies: anterior cruciate ligament (ACL) injury, anterior knee pain (AKP), and knee osteoarthritis (OA). To offer a complete perspective, we draw from studies applying a range of neuroimaging and neurophysiologic techniques. ResultsAdaptations within the motor cortices, corticospinal tract, and motoneuron pool are present in those with knee pathology and underline impairments in quadriceps and hamstrings muscle function. Each pathology has evidence of altered motor system excitability and reduced volitional muscle activation and force-generating capacity, but few impairments were common across ACL injury, AKP, and OA studies. These findings underscore the central role of the motor cortex and motor unit behavior in the long-term outcomes of individuals with knee pathology. ConclusionsAdaptations in the efferent pathways underlie persistent muscle dysfunction across three common knee pathologies. This review provides an overview of these changes and summarizes key findings from neurophysiology and neuroimaging studies, offering direction for future research and clinical application in the rehabilitation of joint injuries.

Ramp Lesions with ACL Injuries Between MRI and Arthroscopic Evaluation.

To compare the accuracy of arthroscopy with MRI in diagnosing ramp lesions associated with anterior cruciate ligament (ACL) injuries. Prospective observational study. Material and Methods: We included 100 patients with complete ACL tear. 1) Partial ACL tear, 2) ACL revision surgery or previous knee surgery, 3) Multi-ligamentous knee injury, 4) Extensive medial meniscus tear. Results: Nine patients were diagnosed with ACL-associated ramp lesions. All nine had magnetic resonance imaging (MRI) signs, but these were not statistically significant ( 2=1.884, FEp=0.348). Mean medial meniscal slope for patients with ramp lesions was 2.88 +- 0.46, without was 2.47 +- 0.55 (T=2.146, P=0.034), implying statistical significance as visualized by arthroscopy. Arthroscopy is superior in diagnosing ramp lesions. Arthroscopy is superior in diagnosing ramp lesions due to cost-effectiveness, direct visualization, and immediate treatment capability. The absence of specific MRI signs for ramp lesions further supports this conclusion.

Schatzker IV tibial plateau fractures involving the posterolateral column: Higher incidence of lateral meniscus and anterior cruciate ligament injuries with suboptimal postoperative outcomes

BackgroundCurrent literature offers scant insights into Schatzker IV tibial plateau fractures (TPFs) that affect the posterolateral (PL) column. This study seeks to elucidate the prevalence of meniscal and ligamentous injuries in the knee, as well as the clinical outcomes, in Schatzker IV TPF cases, both with and without PL column involvement. MethodsWe conducted a retrospective analysis of clinical and imaging data from patients with Schatzker IV TPFs who received surgical treatment at our institution between January 2018 and January 2022. Patient demographics and surgical details were meticulously documented. The study participants were categorized into two groups based on the involvement of the PL column in the Schatzker IV TPF. Group A comprised patients without PL column fractures, whereas Group B included those with such fractures. We compared soft tissue injuries affecting knee stability, namely meniscal and ligamentous injuries, between two groups using Magnetic Resonance Imaging (MRI) and surgical records. Further, Group B was divided into subgroups based on the presence or absence of knee subluxation. Within Group B, we measured the lateral plateau depression (LPD) and lateral plateau widening (LPW). Additionally, we investigated the frequency of meniscus entrapment in patients with PL column fractures. Clinical outcomes were assessed using The American Hospital for Special Surgery (HSS) and Rasmussen scores. ResultsThe study comprised 66 patients with Schatzker IV TPFs. Of these, 12 patients had no PL column fracture, while 54 had a PL column fracture. Group B demonstrated a 57.4 % and 64.8 % incidence of lateral meniscus (LM) and anterior cruciate ligament (ACL) injuries, respectively, significantly higher than that in Group A (25 %, 8.3 %) (p = 0.044, p < 0.001). Within Group B, those with knee subluxation showed a marked increase in LPD (14.5 ± 5.3 mm) and LPW (9.3 ± 4.9 mm), correlating with a higher rate of meniscus entrapment (76.0 %) (p < 0.001). Patients in Group B had lower HSS and Rasmussen scores compared to Group A (p = 0.048, p = 0.006). ConclusionThis investigation reveals that Schatzker IV TPFs involving the PL column are highly associated with increased rates of LM and ACL injuries. Additionally, these fractures correlate with a greater likelihood of knee subluxation and meniscus entrapment, ultimately leading to poorer prognostic outcomes.

Mechanisms and Prevention Strategies of Anterior Cruciate Ligament Injuries in Alpine Skiers

Alpine skiing is a sport enjoyed by more than 50 million people across the world every year. However, despite advancements in safety practices and technology, anterior cruciate ligament (ACL) injuries remain a significant concern. This narrative review investigates the prevalence and mechanisms of ACL injuries in alpine skiing and differentiates between intrinsic (e.g., age, sex, and skill level) and extrinsic factors (e.g., equipment design and environmental conditions) that contribute to the risk of ACL injuries. This article outlines 4 primary mechanisms through which ACL injuries occur, highlighting the complex physical demands of skiing and the role of skier behavior and environmental interactions in injury occurrence. Based on these findings, this article advocates for neuromuscular training (NMT) as a possible effective prevention strategy. NMT enhances muscular coordination and strength, balance, and agility through exercises that mimic skiing movements, potentially lowering the risk of ACL injuries. By providing a detailed analysis of ACL injury risk factors and prevention strategies in the sport, this review offers valuable insights for reducing injury rates and underscores the importance of NMT to mitigate the high incidence of ACL injuries in alpine skiing.

Graft Failure and Contralateral ACL Injuries After Primary ACL Reconstruction: An Analysis of Risk Factors Using Interpretable Machine Learning.

Anterior cruciate ligament (ACL) reconstruction (ACLR) can be successful in restoring knee stability. However, secondary ACL injury, either through graft failure or contralateral injury, is a known complication and can significantly impact the ability of a patient to return successfully to previous activities. To develop and internally validate an interpretable machine learning model to quantify the risk of graft failure and contralateral ACL injury in a longitudinal cohort treated with ACLR. Case-control study; Level of evidence, 3. An established geographic database of >600,000 patients was used to identify patients with a diagnosis of ACL rupture between 1990 and 2016 with a minimum 2-year follow-up. Medical records were reviewed for relevant patient information and 4 candidate machine learning algorithms were evaluated for prediction of graft failure and contralateral ACL injury in patients after ACLR as identified either on magnetic resonance imaging or via arthroscopy. Performance of the algorithms was assessed through discrimination, calibration, and decision curve analysis. Model interpretability was enhanced utilizing global variable importance plots and partial dependence curves. A total of 1497 patients met inclusion criteria. Among them, 140 (9.4%) had graft failure and 128 (8.6%) had a contralateral ACL injury after index surgery at a median follow-up of 140.7 months (interquartile range, 77.2-219.2 months). The best performing models achieved an area under the receiver operating characteristics curve of 0.70 for prediction of graft failure and 0.67 for prediction of contralateral ACL injury, outperforming a logistic regression fitted on the identical feature set. Notable predictors for increased risk of graft failure included younger age at injury, body mass index (BMI) <30, return to sports <13 months, initial time to surgery >75 days, utilization of allograft, femoral/tibial fixation with suspension/expansion devices, concomitant collateral ligament injury, and active or former smoking history. Predictors of contralateral ACL injury included greater preoperative pain, younger age at initial injury, BMI <30, active smoking history, initial time to surgery >75 days, history of contralateral knee arthroscopies, and involvement in contact sports. Less than 18% of all patients who undergo ACLR should be expected to sustain either a graft failure or contralateral ACL injury. Machine learning models outperformed logistic regression and identified greater preoperative pain, younger age, BMI <30, earlier return to higher activity, and time to surgical intervention >75 days as common risk factors for both graft failure as well as contralateral ACL injury after ACLR. Surgeon-modifiable risk factors for graft failure included allograft and femoral/tibial fixation with a suspension/expansion combination.

Clinical Utility of Qualitative Change of Direction Movement Assessment in ACL Injury Risk Evaluation.

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How Athletic Swiss Patients Experience Their Return to Sports After Anterior Cruciate Ligament Reconstruction: Results from a Retrospective Self-Assessment.

Anterior cruciate ligament (ACL) ruptures are frequent injuries, especially in athletes. Return to sports after reconstruction of the ligament is a frequently debated topic and of high relevance for these patients. It is mostly achieved at 9-12 months post-surgery. However, the risk of subsequent knee injuries is high and psychological factors play an important role in the process and success of returning to sports. Little is known about patients' perception of their journey returning to sports. This study aims to fill the gap. The study aimed to include patients treated surgically for an ACL injury over 5 years at a specialized sports-medicine clinic. Patients were surveyed on the impact of the injury on their lives, their return to sports experience, and medical history. In total, 100 (of 474) patients aged 35.9 years responded. Within 5 years, 19% experienced a reoperation and 23% a new knee injury. Overall, 83% of patients returned to their main sport, 72% reached their pre-injury level. However, 45% reported at least one distinct or severe consequence of their ACL injury. The ability to return to sports had more impact on the perception of the course of treatment than the experience of new injuries or surgery. The rate of successful return to sports was comparable to previous reports despite a higher average age in this cohort. A successful return to sports seems to be a major determinant for the perception of impact from the injury and may be more important than the avoidance of repeat trauma.

Ultra-thin and sensitive pressure sensor based on MXene/PVDF-HFP composite fiber TENG for self-diagnosis of ligament injuries

Early screening of anterior cruciate ligament (ACL) injuries using wearable devices enables timely intervention and reduces the risk of chronic complications. However, the subtle biomechanical signals of the ACL pose challenges to the baseline stability, sensitivity and skin adherence of wearable devices. Here, we present a TENG based on MXene/PVDF-HFP composite fibers for ACL self-diagnosis, leveraging the inherent advantages of TENG in baseline stability. The fiber-network structure prepared by electrospinning ensures that the TENG is ultra-thin and flexible to wear. The addition of MXene significantly increases the relative permittivity of the electrode materials, and re-modulates the crystalline phase (α and β). Consequently, the peak-to-peak open circuit voltage of the TENG reaches 160 V under a pressure of 10 N. It can respond to pressures as low as 0.01 N, allowing it to distinguish subtle relative displacements between the tibia and the knee. Integrated with a mobile app, a self-diagnostic system capable of detecting varying degrees of ACL injury has been developed. We expect this approach to facilitate the early detection and timely treatment of ACL injuries.

“ACL - wow, this is bad”: People’s perceptions about their anterior cruciate ligament injury and its care - a systematic review and qualitative evidence synthesis

“ACL - wow, this is bad”: People’s perceptions about their anterior cruciate ligament injury and its care - a systematic review and qualitative evidence synthesis

Psychometric properties analysis of Indonesian IKDC scale for managing patients with ACL injury

Psychometric properties analysis of Indonesian IKDC scale for managing patients with ACL injury

Evaluation of healing after arthroscopic repair of lateral meniscal tears around the popliteal hiatus

BackgroundThe popliteal hiatus stabilizes the lateral meniscus (LM). Variable failure rates for LM repairs have been reported in knees with lateral meniscal tears (LMTs), which may be attributable to low vascularity around the popliteal hiatus. An effective repair method is essential to enhance the biological healing and stability of LMTs around the popliteal hiatus. HypothesisArthroscopic repair of LMTs, including the popliteus tendon around the popliteal hiatus, is expected to produce a low reoperation rate and effective treatment, both clinically and radiographically. Material and methodsFrom June 2011 to August 2020, 93 patients (mean age 27.9 ± 13.5 years) who underwent arthroscopic repair of LMTs including the popliteus tendon around the popliteal hiatus were enrolled. Patients with LMTs were divided into three groups: isolated LMTs, discoid LMTs, and LMTs with ACL injury. Patients had a minimum clinical follow-up of 2 years (mean 37.9 ± 19.3 months) and Tegner activity, Lysholm knee, and Hospital for Special Surgery (HSS) scores were evaluated for all patients. The widths of the popliteal hiatus and LM extrusion were measured on the sagittal and coronal planes using preoperative and postoperative magnetic resonance imaging (MRI). ResultsThe Tegner activity (2.6 ± 1.2–4.5 ± 1.3), Lysholm (67.9 ± 14.2–88.1 ± 6.4), and HSS scores (79.8 ± 11.5–93.7 ± 5.1) were significantly improved in all knees (p < 0.001). The width of the popliteal hiatus measured on MRI was significantly decreased, when comparing the preoperative and postoperative MRI for all knees (sagittal plane, 2.9 ± 1.4–1.5 ± 0.5 mm; coronal plane, 3.8 ± 2.5 to 1.9 ± 1.0 mm) (p < 0.05). The LM extrusion measured on the sagittal plane of postoperative MRI was also significantly reduced after arthroscopic repair (24.8 ± 3.1–23.7 ± 2.8 mm) (p = 0.001). Five reoperations (5/93, 5.3%) were performed, suggesting a clinical failure. ConclusionArthroscopic repair of isolated, discoid and post-traumatic LMTs including the popliteus tendon around the popliteal hiatus, is an effective surgical treatment for LM stabilization. Level of evidenceLevel IV, retrospective series.

History Of Concussion Or ACL Injury Is Not Associated With Worse Health-Related Quality Of Life Scores In Collegiate Student-Athletes.

History Of Concussion Or ACL Injury Is Not Associated With Worse Health-Related Quality Of Life Scores In Collegiate Student-Athletes.