Knee Trauma Research Articles

The Role of Magnetic Resonance Imaging in Traumatic Knee Injury

Introduction: Magnetic Resonance Imaging (MRI) as a non-invasive modality plays a vital role in assessment of a wide spectrum of internal knee derangements. This study focuses on the commonest anatomical derangement and reveals the importance of MRI to characterize the pattern of derangement in the assessment of the patient with knee injury.
 Methods: This is the hospital based prospective study conducted among 65 patients referred to department of radiology with first presentation of knee injury during two years period from August, 2013 to August, 2015. Patient fulfilling the inclusion criteria underwent Magnetic Resonance Imaging knee in SIEMENS MAGNETOM C 0.35 Tesla MRI machine, after taking written informed consent. Descriptive analysis of data was analyzed using SPSS 20.0 program
 Result: Of the total 65 patients with knee injury, Sport injuries were the most common mode of knee injury. 63 cases with trauma had findings on MRI. Most of the cases presented with joint effusion (59 cases). Anterior Cruciate Ligament (ACL) tear is the commonest injury (37 cases) during knee trauma followed by Medial Collateral Ligament (MCL), Medial Meniscus, Posterior Cruciate Ligament (PCL), Lateral Meniscus and Lateral Collateral Ligament(LCL) injuries.
 Conclusion: MRI as a high-contrast soft-tissue imaging technique can be used as a noninvasive modality to assess a wide spectrum of internal knee derangements in a patient with knee injury. Specific pattern of bone bruise can guide us to narrow our diagnosis.

CT diagnosis of bucket handle meniscus tear

Bucket handle meniscus tears are difficult to diagnosis and are one of the most frequently missed tear patterns on magnetic resonance imaging (MR). However, this meniscal injury often requires arthroscopic intervention and preoperative characterization of the tear is important to orthopedic surgeons for treatment planning. MR is currently the best imaging modality for evaluating meniscal tears, but trauma patients in the emergency room more often undergo radiographs and further evaluation with computed tomography (CT) exams. To date, there is one study from 1988 that reported the value of CT in diagnosing bucket handle meniscus tears. We present an informative case of bucket handle meniscus tear after acute traumatic knee injury that was diagnosed on CT and later confirmed on arthroscopy.

Can the distal tibial insertion of the anterolateral ligament be palpated to identify lesions in anterior cruciate ligament tears?

Background:It has been established that the anterolateral ligament (ALL) plays a role in controlling the rotational stability of the knee. We have demonstrated that ALL injuries can be identified by ultrasound. In most instances, the injury is tibial. The objective of this study was to evaluate the correlation between acutely painful palpation of the distal insertion of the ALL and the lesion as observed on ultrasound.Methods:We conducted a prospective single center study with 130 patients (89 men and 41 women). The mean age was 27.2 ± 8.3 years and the subjects had unilateral ACL injury for less than one month. On average, the distal insertion was palpated 8.8 ± 3.2 days after the trauma to determine the pain status of the ALL. An ultrasound was performed preoperatively by a surgeon trained in ultrasound diagnosis. All assessments were conducted in a double blind method (the surgeon did not know the clinical status of the ALL). We measured the correlation between the ALL ultrasound injury assessment and pain on palpation of the distal insertion using the intra-class correlation coefficient with a 95% confidence interval. The correlation between the preoperative pivot shift grade in the operating room and the ultrasound injury assessment was also examined. This study was approved by the ethics committee. Considering that the objective could not be quantified, the number of subjects required was determined by recruitment for 1 year.Results:The consistency between painful palpation of the distal insertion of the ALL and the ultrasound injury assessment was good with a 95% confidence interval of the ICC at 0.801 (95% CI: 0.730, 0.855)The sensitivity of this clinical test was 92% (95% CI: 88-97), specificity, 88 (95% CI: 82-93), the positive predictive value, 88% (95% CI: 82-94) and the negative predictive value, 92% (95% CI: 87 -97).The consistency between the pivot shift grade in the operating room and the injury on ultrasound was good, ICC = 0.850 (95% CI: 0.794, 0.891)Conclusion:The diagnostic value of painful palpation of the distal insertion of the ALL in identifying ALL injury was excellent.This structure is involved in the rotational stability of the knee. Therefore, assessment by palpation is adapted to the specific management of knee trauma.

Management of neglected distal femur epiphyseal fracture-separation.

Neglected epiphyseal fracture-separations of the distal femur are rare. Still reported in developing countries, they lead to therapeutic issues. The objective of the study is to describe their characteristics and to propose treatment options. Ten years of ongoing study was held in our orthopedics department. All patients with a neglected epiphyseal fracture-separations of the distal femur after a knee trauma were included in the study. Pre-operative and post-operative data were collected and analyzed. A total of 13 cases of neglected traumatic epiphyseal fracture-separations of the distal femur were found among 8616 in-patients of the department. It was mainly boys (9M/4F) around 16 years that were received 14 weeks after knee trauma. Most of the injuries were an AO-type 33-E/2.1 (Simple Salter-Harris' type II) (n=12) distal femur malunion (n=10). Associated complications were cutaneous opening (n=7), superficial infection (n=4), deep infection (n=4). Fractures were management surgically (n=12) by an open osteoclasis procedure (n=9), debridement (n=7) and a thigh amputation (n=1). The outcome was better if an open osteoclasis procedure was early performed in closed distal femur mal-union with a complementary rehabilitation program. Specialized trauma care facilities must be increased, and trauma education programs must be undertaken to avoid neglected epiphyseal fracture-separations of the distal femur in developing countries.

An Observational Study of the “Unhappy Triad” in Female Athletes

The “unhappy triad” (anterior cruciate ligament, medial collateral ligament, and medial meniscal tears) injury pattern in knee trauma, as originally described by O'Donoghue in 1950, has been taught in physician assistant and athletic training curriculum for decades. Our study suggests that female athletes sustain a different injury pattern, regarding knee trauma, that differs from the classic “unhappy triad” pattern.

Comprehensive application of high tibial osteotomy, chronic distraction tissue regeneration, and computer-assisted external fixation in the treatment of severe knee osteoarthritis

RationaleKnee osteoarthritis (KOA) is a common disease. It has long been believed that the main causes of KOA are knee degenerative diseases, trauma, overwork, and labor habits. However, long-term deformity leads to uneven stress on the surface of the knee joint, and the cause of lower limb force line damage has not been taken seriously. Comprehensive application of high tibial osteotomy (HTO), chronic distraction tissue regeneration, and computer-assisted external fixation for the treatment of severe KOA has many advantages over total knee arthroplasty, such as lasting and thorough orthopedic effects, a lower cost, and a faster recovery.Patient concernsThe patient was a 48-year-old male with KOA caused by long-term genu varus, resulting in pain in both knees, especially in the right knee. The right knee pain had been aggravated for 2 years, and he was admitted to the hospital for left knee pain for 1 month.DiagnosesX-ray: The patient has right KOA and varus deformityInterventionsComprehensive application of HTO, chronic distraction tissue regeneration technology, and computer-assisted external fixation technology has a good therapeutic effect for patients with KOA and varus.OutcomesThe patient's severe genu varus was corrected, the bone and soft tissue regeneration was good, the lower limb force line was improved, lower limb function was restored well, and the treatment was satisfactory.ConclusionFor the treatment of KOA patients with genu varus, the combination of HTO, chronic distraction tissue regeneration, and computer-assisted adjustment of external fixation technology have a good effect on the correction of genu varus deformity and the recovery of the lower limb force line. This treatment method is also conducive to preventing postoperative infection and avoiding secondary trauma caused by the removal of internal fixation plates.

A new tool for early diagnosis of rheumatoid arthritis using combined biomarkers; synovial MAGE-1 mRNA and serum anti-CCP and RF.

Introductionrheumatoid arthritis (RA) is a common autoimmune disease with unknown etiology and pathogenesis. Biomarkers have the potential to aid in the clinical diagnosis of the disease, or to provide means of detecting early signs of the disease. Evaluating Melanoma associated antigen genes (MAGE-1) mRNA expression rate in synovial fluid cells and serum levels of anti-cyclic citrullinated peptides (anti-CCP) and rheumatoid factor (RF) for RA early diagnosis.Methodsa total of 213 subjects were enrolled in the study, 135 RA patients and 78 normal subjects with traumatic knee joints (control group). Serum RF and anti-CCP were estimated quantitatively using ELISA. MAGE-1 mRNA expression rate was analyzed by RT-PCR.Resultsa significant increase in serum levels of RF IgM and anti-CCP in RA patients compared to the controls. A positively significant correlation was found between serum anti-CCP and RF IgM. The expression rate of MAGE-1 mRNA was 100% in RA patients versus the controls (0%). The specificity and the sensitivity of the three biomarkers was 100%.Conclusionthe high expression rate of MAGE-1 in synovial fluid cells of RA patients is encouraging its utilization as a diagnostic biomarker for RA. The combined use of MAGE-1 transcript in synovial fluid cells, serum RF and anti-CCP is recommended for improving early diagnostic ability of RA.

A Case of Knee Trauma Managed with Intra-soft Tissue and Intra-medullary Antibiotics Perfusion

A Case of Knee Trauma Managed with Intra-soft Tissue and Intra-medullary Antibiotics Perfusion

The Association Between Anterior Cruciate Ligament Length and Femoral Epicondylar Width Measured on Preoperative Magnetic Resonance Imaging or Radiograph

PurposeTo determine whether femoral epicondylar width (FECW) obtained from either magnetic resonance imaging (MRI) or plain radiographs could be used to predict anterior cruciate ligament (ACL) length. A secondary purpose was to develop a formula to use maximum FECW on either MRI or plain radiographs to estimate ACL length preoperatively.MethodsThe MRIs and radiographs of 40 patients (mean age 41.0 years), with no apparent knee pathology, surgery, or trauma were included. The ACL length was measured on MRI followed by FECW on both MRI and radiograph of the same patient. This allowed the development of equations able to predict ACL length according to the FECW measured on either an MRI or radiograph.ResultsThe mean ACL length was 40.6 ± 3.6 mm. FECW measured on both MRIs and radiographs was sufficient to predict ACL length. Pearson’s correlations revealed a high positive relationship between ACL length and FECW on MRI (r = 0.89, P < .0001) and ACL length and FECW on radiograph (r = 0.83, P < .0001). The coefficient of determination (R2) was calculated to be MRI: R2 = 0.78 and radiograph: R2 = 0.68 and confirmed that FECW measured on both MRI and radiograph were sufficient to predict ACL length. Based on these models, ACL length can be predicted by FECW using the following formulas: MRI: ACL length = 0.47 (FECW) + 1.93 and radiograph: ACL length = 0.31 (FECW) + 11.33.ConclusionsThis study demonstrated that FECW measured on either MRI or anteroposterior radiograph could reliably estimate ACL length on a sagittal MRI. There was a high positive relationship between ACL length and FECW on both MRI and radiographs, although MRIs do predict ACL length more reliably.Clinical RelevancePreoperative ACL length assessment, using FECW on MRI or radiograph, is useful in graft selection and in preventing inadequate graft harvesting for ACL reconstruction, especially if an individualized anatomical approach is pursued.

A novel autologous-made matrix using hyaline cartilage chips and platelet-rich growth factors for the treatment of full-thickness cartilage or osteochondral defects: Preliminary results

To report the clinical, functional, and magnetic resonance imaging (MRI)-based outcomes of a novel autologous-made matrix consisting of hyaline cartilage chips combined with mixed plasma poor rich in platelets clot and plasma rich in growth factors (PRGF) for the treatment of knee full-thickness cartilage or osteochondral defects. Between July 2015 and January 2018, all patients with full-thickness cartilage or osteochondral defects undergoing this novel cartilage restoration surgical technique were approached for eligibility. Indications for this procedure included traumatic or atraumatic full-thickness knee cartilage defects or osteochondritis dissecans. Patients were included if they had no concomitant use of stem cells, previous ipsilateral cartilage repair procedure, or follow-up was less than 10 months. The outcomes included data on current symptoms, physical exam, patient-reported, and functional outcomes (visual analogue scale (VAS) for pain, Lysholm score, Tegner activity scale, International Knee Documentation Committee (IKDC) subjective form, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Lequesne index, and short form-12 (SF-12)) and the magnetic resonance observation of cartilage repair tissue (MOCART) score. These outcomes were compared to preoperative values, except for the MOCART score. Fifteen patients were included in this preliminary study: mean (standard deviation (SD), range) follow-up 15.9 months (7.2, 10-32), age 26.8 years (12.1, 16-58), and body mass index 23.2 (2.1, 19.3-26.9). There were 14 men (93%) and 1 woman (7%). There was a statistically significant improvement between pre- and postoperative periods for VAS for pain (p = 0.003), Lysholm score (p = 0.002), IKDC subjective form (p = 0.003), WOMAC for pain (p = 0.005), WOMAC for stiffness (p = 0.01), WOMAC for function (p = 0.002), Lequesne Index (p = 0.002), and SF-12 physical component summary (p = 0.007). The postoperative mean (SD; range) MOCART score was 70 (12.4; 40-85). The use of this novel cartilage restoration surgical technique provides excellent clinical, functional, and MRI-based outcomes in young, active individuals with full-thickness cartilage or osteochondral defects. Level IV-Therapeutic case series.

Artesunate prevents knee intraarticular adhesion via PRKR-like ER kinase (PERK) signal pathway

BackgroundIntraarticular scar adhesion refers to a serious complication caused by knee surgery or trauma, leading to various sequelae (e.g., articular cartilage degeneration and knee joint stiffness). Artesunate (ART) has exhibited an effect to suppress fibroblast proliferation, whereas the exact mechanism remains unclear. This study aims to delve into the possible mechanism of ART in suppressing joint adhesion.MethodsThe effect of ART on reduced intraarticular adhesions was ascertained by histological staining and immunohistochemical analysis through vivo experiments. Cell Counting Kit-8 (CCK-8) assay, Western blot analysis, flow cytometry, and tunnel staining were used to detect the effect of ART in promoting fibroblast apoptosis and delve into its possible signaling pathway.ResultsThe results of hematoxylin-eosin (HE) staining suggested that the number of fibroblasts decreased with the increase in ART concentration. The results of Masson staining were similar, with the increase in concentration, the collagen content decreased. Immunohistochemical results showed that the expression of endoplasmic reticulum stress (ERS) characteristic proteins 78 kDa glucose-regulated protein 78 (GRP78) and C/EBP homologous protein (CHOP) increased in a concentration-dependent manner. CCK-8 results suggested that ART could inhibit fibroblast viability in a concentration- and time-dependent manner. Results of flow cytometry, tunnel staining, and Western blot suggested the apoptosis of fibroblasts occurred after ART treatment. Cells with caspase inhibitors were treated, and apoptotic proteins cleaved-poly ADP-ribose polymerase (cleaved PARP) and cleaved-caspase 3 were detected; the results showed that the apoptotic effect of ART was reduced. The expressions of ERS-related protein CHOP and apoptosis-related protein Bax were upregulated, while the expression of Bcl-2 was downregulated, and the ratio of Bax/Bcl-2 increased in a concentration-dependent manner. Continuous detection of PRKR-like ER kinase (PERK) pathway-related proteins showed that the expression of p-PERK and phosphorylating eukaryotic initiation factor 2α (p-eIF2α) increased in a time-dependent and concentration-dependent manner. PERK pathway inhibitors could partially inhibit ART-mediated apoptosis through PERK pathway.ConclusionsART can promote fibroblast apoptosis through PERK pathway, a classical ERS pathway, and thus prevent fibrosis in the surgical area after joint surgery.

Endovascular Stent Graft Repair of Traumatic Popliteal Artery Injuries

Introduction: Popliteal artery injury is a potentially-limb threatening complication of traumatic knee dislocation. The purpose of this study was to evaluate the feasibility and effectiveness of endovascular repair of traumatic popliteal a3.102rterial injuries. Methods: A retrospective analysis of 11 patients with clinical suspicion of popliteal arterial injuries that were confirmed by arteriography was performed from September 2015 to June 2017. Clinical data included demographics, mechanism of injury, type of injury, location of injury, concomitant injuries, time of endovascular procedures, time interval from trauma to blood flow restoration, and follow-up. All patients were male (mean age of 32.7 ± 8.5 years) and suffered traumatic knee dislocation along with significant ligament and neurovascular injuries. The type of lesion involved dissection (n = 3), partial transection (n = 5), complete transection (n = 2), arteriovenous fistula (n = 1). All patients underwent endovascular repair with Viabahnâ stent graft for popliteal arterial injuries. Results: Technical success rate was 100%. No perioperative death and procedure-related complication occurred. The length of the stent graft ranged between 5 and 10 cm; the diameter of the stents was 6 mm. The average follow-up was 22.4 ± 5.6 months (range 16–25 months). One patient who underwent knee arthroplasty with tourniquet treated with catheter directed thrombolysis due to stent thrombosis at 19 months after the procedure. All limbs were salvaged. Stent graft migration, deformation, or fracture was not found during the follow-up. Conclusion: Traumatic knee dislocations are rare injuries that may be associated with potentially devastating vascular complications. A prompt diagnosis and timely arterial repair is of paramount importance if limb salvage is to be achieved. In complicated traumatic popliteal artery injuries, an endovascular stent graft implantation as a backup or bail-out technique might be a valid option in some selected cases. Further studies are required to evaluate the long-term efficacy of endovascular stent graft repair.

Evaluation of Various Types of Traumatic Knee Injuries by Magnetic Resonance Imaging (MRI)

Evaluation of Various Types of Traumatic Knee Injuries by Magnetic Resonance Imaging (MRI)

Analysis of lncRNA expression profiles by sequencing reveals that lnc-AL928768.3 and lnc-AC091493.1 are novel biomarkers for disease risk and activity of rheumatoid arthritis.

This study aimed to analyze long non-coding RNA (lncRNA) expression profiles in synovium tissue of patients with RA using RNA sequencing, and to further assess the clinical values of dysregulated lncRNAs in RA diagnosis and monitoring. Thirty patients with RA who underwent knee arthroscopy and 30 controls with knee trauma who underwent surgery were consecutively enrolled and synovium tissue samples of both groups were obtained during surgery. In the exploration stage, lncRNA and mRNA expression profiles in three RA samples and three control samples were detected by RNA sequencing and bioinformatic analyses were then performed. In the validation stage, quantitative polymerase chain reaction (qPCR) was subsequently used to detect expression of five candidate lncRNAs in 30 patients with RA and 30 control patients. A total of 349 lncRNAs and 1582 mRNAs were upregulated and 806 lncRNAs and 1295 mRNAs were downregulated in patients with RA compared with controls. Enrichment analyses revealed that these dysregulated lncRNAs and mRNAs were mainly involved in regulating immune response, leukocyte migration, complement activation, and Bcell receptor signaling pathway. Subsequent qPCR validation discovered that lnc-AL928768.3 (P < 0.001) and lnc-AC091493.1 (P < 0.001) were elevated in patients with RA compared with controls and afford good predictive values for RA risk by receiver operating characteristic (ROC) curve analysis. Additionally, the two lncRNAs were positively associated with C-reactive protein level and disease activity score in 28 joints (ESR) (all P < 0.05). Analysis of lncRNA expression profiles by sequencing reveals that lnc-AL928768.3 and lnc-AC091493.1 are novel biomarkers for RA risk and activity.

Traumatic injury of the knee extensor mechanism in skeletally immature patients: Outcome and classification

BackgroundThe literature is limited on the etiology and outcome of acute traumatic knee extensor mechanism injuries in skeletally immature patients with lack of a reliable classification system. MethodsData on patients who sustained an acute traumatic injury of the knee extensor mechanism were reviewed with a minimum of 12-month follow-up. Functional outcome was evaluated regarding knee active range of motion. Functional outcome was described using the Knee Society Score (KSS). Data were expressed as mean ± standard deviation. ResultsSeventy-two patients with 74 knee extensor mechanism injuries were identified. The age at the time of injury was 13.9 ± 1.9 years. They included 59 injuries with tibial tubercle avulsion fracture, six injuries with patellar tendon avulsion without bone injury, six injuries with combined patellar tendon avulsion with tibial tubercle fracture, two injuries with sleeve fracture, and one injury with quadriceps tendon avulsion. According to our classification, type IB1 injury was the commonest injury (79.7%). The time to return to sports was 5.23 ± 2.98 months. The flexion was 128.7° ± 13.3°. A mean terminal extension lag of 5.6° was detected in three patients (4.1%). The KSS was 94.8 ± 8.1 and the functional outcome was graded excellent in 64 patients (88.9%), good in seven patients (9.7%), and fair in one patient (1.4%). ConclusionsTraumatic injuries of the knee extensor mechanism in skeletally immature patients represent a wide variety of injuries including bony injuries in 82.4% of cases reviewed, tendinous injuries in 9.5%, and both bone and tendinous injuries in 8.1%. Our proposed classification system provides a more precise description of the injury pattern.

Rehabilitation Medicine in Pellegrini-Stieda Syndrome with Myositis Ossificans and Neglected Patella Fracture

Introduction: Pellegrini-Stieda Syndrome (PSS) is calcification of the medial collateral ligament(MCL). The manifestation are restricted motion and pain of the knee. PSS usually associated withtrauma or repeated strain.Methods: A case report of 30 year old physically active men has a severe stiffness and pain on the leftknee while walking for six months. He had neglected trauma 9 years ago. There were antalgic gait,mild swelling, warm, and tenderness on medial aspect, restricted range of motion (ROM) by pain on theleft knee; flexion 150. The knee X-Ray has shown the myositis ossificans and Pellegrini-Stieda lesion.Subject had undergone Rehabilitation Program, i.e. progressive gradual motion exercise and cryotherapyResults: There were reduced of pain, and increase the Left knee PROM were 15º restricted of extensionand 30º flexion, became 8ºrestricted of extension and 55º flexion, after one month of program.Conclusion: Pellegrini-Stieda Syndrome (PSS) is a possible complication in major knee trauma. Thepatient showed improvements in pain, and ROM after one month of rehabilitation programs.Keywords: Pellegrini-Stieda Syndrome (PSS), Range-of-Motion (ROM), Medial Collateral Ligament(MCL).

Rehabilitation Medicine in Pellegrini-Stieda Syndrome with Myositis Ossificans and Neglected Patella Fracture

Introduction: Pellegrini-Stieda Syndrome (PSS) is calcification of the medial collateral ligament (MCL). The manifestation are restricted motion and pain of the knee. PSS usually associated with trauma or repeated strain. Methods: A case report of 30 year old physically active men has a severe stiffness and pain on the left knee while walking for six months. He had neglected trauma 9 years ago. There were antalgic gait, mild swelling, warm, and tenderness on medial aspect, restricted range of motion (ROM) by pain on the left knee; flexion 150. The knee X-Ray has shown the myositis ossificans and Pellegrini-Stieda lesion. Subject had undergone Rehabilitation Program, i.e. progressive gradual motion exercise and cryotherapy Results: There were reduced of pain, and increase the Left knee PROM were 15º restricted of extension and 30º flexion, became 8ºrestricted of extension and 55º flexion, after one month of program. Conclusion: Pellegrini-Stieda Syndrome (PSS) is a possible complication in major knee trauma. The patient showed improvements in pain, and ROM after one month of rehabilitation programs.

Screening of Trauma Patients in Need of Knee Radiography by Triage Nurses and Using Ottawa Knee Rule; a Letter to Editor.

In some clinical guidelines, emergency triage nurses request radiographies according to the clinical decision-making priorities. While some studies have suggested that nurses are not as accurate as doctors in assessing major complications of trauma to the knee, it is thought that they are as capable in detecting minor traumas and inconsequential episodes (1). Many studies have shown that the cost of treatment and the waiting period for patients in the emergency department decrease without missing fractures when traumas are initially assessed by a certified nurse. Routinely, a clinical criteria termed Ottawa Knee Rule is utilized to determine if a patient is in need of a knee radiography or not (2, 3). According to this guideline, if a patient with suspected knee trauma meets any of the following criteria, he or she should undergo imaging modalities: Age above 55 years, tenderness at head of fibula, isolated tenderness of patella, inability to flex the knee more than 90°, and inability to bear weight (4).

Does MRI add value in general practice for patients with traumatic knee complaints? A 1-year randomised controlled trial

ObjectiveTo determine whether referral to MRI by the general practitioner (GP) is non-inferior to usual care (no access to MRI by GPs) in patients with traumatic knee complaints regarding knee-related...

Traumatic knee injury patterns in Anatolian folk dancers: a case series and literature review.

Lower extremities, especially the knee region, are susceptible to traumatic injuries because of long-lasting hard landings and impacts. Most of the injuries described in the literature are associated with ballet. In this review study, the authors tried to present the traumatic knee injury patterns of the Anatolian folk dance. The Fire of Anatolia dance group consists of 82 dancers (37 males [45.1%] and 45 females [54.9%]) with the mean age of 27.96 (SD = 5.05) years (range: 18-38 years). The major folk dances of the region are Zeybek, Halay, Horon, Teke, Roman, Karsilama, Bar and Lezginka ("the Caucasian"). The dancers suffered from 9 orthopedic injuries requiring surgical treatment (3 meniscus tears, 4 anterior cruciate ligament tears, 1 posterior cruciate ligament tear, 1 patellar dislocation) during a 10-year period. The authors investigated solely the traumatic injuries of these folk dance styles and aimed at revealing the traumatic knee injury patterns in this case series and literature review. On the one hand, the Anatolian folk dancers experienced meniscus tears following frequent squats and twists on single leg stances, typical of Horon and Zeybek. On the other hand, anterior cruciate tears happened after jumps and landings in the Caucasian (Lezginka jump) dance. A posterior cruciate ligament tear was also seen after the Caucasian dance landing. The split figure in the Karsilama dance ended up with patellar dislocation. Certain dance figures seem to be related to specific types of injuries. Int J Occup Med Environ Health. 2019;32(5):585-93.