Article

A prospective magnetic resonance imaging study of the incidence of posterolateral and multiple ligament injuries in acute knee injuries presenting with a hemarthrosis

Sports Medicine and Shoulder Divisions, Department of Orthopaedic Surgery, University of Minnesota, Minneapolis 55454, USA.
Arthroscopy The Journal of Arthroscopic and Related Surgery (Impact Factor: 3.19). 01/2008; 23(12):1341-7. DOI: 10.1016/j.arthro.2007.07.024
Source: PubMed

ABSTRACT The purpose of this study was to determine whether the incidence of posterolateral knee injuries, as well as other concurrent knee ligament injuries, could be obtained from a prospective evaluation of magnetic resonance imaging scans in patients with an acute knee injury with a hemarthrosis.
We prospectively documented all patients with acute (within 30 days) knee injuries with a hemarthrosis over a 90-day period who underwent 1.5-T magnetic resonance imaging at a large referral imaging facility with 6 sites, effectively covering a large metropolitan area. The anterior cruciate ligament, superficial medial collateral ligament, and posterior cruciate ligament (PCL) and the following individual structures of the posterolateral corner were evaluated for high-grade injury: fibular collateral ligament, popliteus tendon, and popliteofibular ligament.
Out of 331 consecutive acute knee injuries with a hemarthrosis, 265 ligament injuries occurred in 187 patients (56%). Of these 187 patients with ligament injuries, 126 had isolated ligament injuries and 61 (33%) had combined multiple ligament injuries. Of the 187 patients with knee ligament injuries, 83 (44%) had isolated anterior cruciate ligament tears, 28 (15%) had isolated superficial medial collateral ligament tears, 11 (5%) had isolated PCL tears, and 4 (2.1%) had isolated posterolateral knee tears. Of the patients with posterolateral knee structure injuries, 87% (26/30) had multiple ligament injuries, with the overall incidence of posterolateral knee injuries among all knee ligament injuries being 16% and among all acute knee injuries with a hemarthrosis being 9.1%. Of the 27 patients with PCL tears, 16 (52%) had combined multiple ligament injuries.
This study shows that in this population, the incidence of posterolateral knee injuries in patients with acute knee ligament injuries with a hemarthrosis was 9.1%. It also verified that most PCL and posterolateral corner injuries occur in combination with other ligament injuries.
Level II, development of diagnostic criteria on the basis of consecutive patients with a universally applied gold standard.

0 Followers
 · 
116 Views
  • Source
    01/2013; 13:22-26. DOI:10.4103/1319-6308.112217
  • [Show abstract] [Hide abstract]
    ABSTRACT: This article describes the presentation of a patient with knee swelling following injury. It tests and explains the various clinical aspects that are important for a resident to know in assessment, diagnosis and management of this presentation.
    08/2014; DOI:10.1016/j.jajs.2014.06.002
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose The purpose of this epidemiologic study was to quantify the incidence, expense, and concomitant injuries for anterior cruciate ligament reconstruction (ACLR) procedures in the USA from 2003 to 2011 that required an inpatient stay. It was hypothesized that the relative reported rates of concomitant knee injuries would be greater with the MCL and menisci compared to all other concomitant knee injuries. Methods The National Inpatient Sample from 2003 to 2011 was retrospectively sampled using ICD-9-CM codes to identify ACLR patients and to extrapolate national averages. Results Between the years of 2003–2011, an average of 9,037 ± 1,728 inpatient hospitalization included ACLRs, of which 4,252 ± 1,824 were primarily due to the ACLR. Inpatient visits primarily due to ACLR involved an average hospitalization of 1.7 ± 0.2 days and cost $30,118 ± 9,066 per patient. Knee injuries that were commonly reported along with inpatient ACLRs included medial meniscus damage (18.1 %), lateral meniscus damage (16.8 %), collateral ligament repairs (12.3 %), and medial collateral ligament strains (6.9 %). Prevalence of meniscus injuries was consistent across years, but MCL-related injuries increased over time. Conclusions ACLR-related inpatient hospitalizations account for approximately 7.1 % of the total ACLRs performed annually in the USA. Inpatient ACLR procedures continue to decrease in frequency; however, the mean cost per patient increased. Meniscus and collateral ligament injuries were the most commonly reported concomitant knee injuries. The clinical relevance of this investigation is that it informs, on a large clinical cohort of patients, the current state of incidence and expense for ACLR surgeries in an inpatient setting. Level of evidence Prognostic, retrospective study, Level II.
    Knee Surgery Sports Traumatology Arthroscopy 12/2014; DOI:10.1007/s00167-014-3478-3 · 2.84 Impact Factor

Full-text (2 Sources)

Download
9 Downloads
Available from
Oct 3, 2014