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Incidence and patterns of meniscal tears accompanying the anterior cruciate ligament injury: possible local and generalized risk factors

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Abstract

Aim of the work

Injury to the anterior cruciate ligament (ACL) is frequently accompanied by tears of the menisci. Some of these tears occur at the time of injury, but others develop over time in the ACL-deficient knee. The aim of this study was to evaluate the effects of the patient characteristics, time from injury (TFI), and posterior tibial slope (PTS) on meniscal tear patterns. Our hypothesis was that meniscal tears would occur more frequently in ACL-deficient knees with increasing age, weight, TFI, PTS, and in male patients.

Methods

Of the ACL-injured patients, 362 were analyzed, and details of meniscal lesions were collected. The medial and lateral tibial slopes (MTS, LTS) were measured via computed tomography. Patient demographics, TFI, MTS, and LTS were correlated with the diagnosed meniscal tears.

Results

Of the patients, 113 had a medial meniscus (MM) tear, 54 patients had a lateral meniscus (LM) tear, 34 patients had tears of both menisci, and 161 patients had no meniscal tear. The most common tear location was the posterior horn (PH) of the MM, followed by tear involving the whole MM. Patient age, BMI, and TFI were significantly associated with the incidence of MM tear. Female patients had a higher incidence of injury than males in all tear sites except in the body and PH. Male patients had more vertical and peripheral tears. The median MTS and LTS for patients with MM tears were 7.0°and 8.7°, respectively, while those of patients with LM tears were 6.9° and 8.1°. Steeper LTS was significantly associated with tears of LM and of both menisci.

Conclusion

Older age, male sex, increased BMI, and prolonged TFI were significant factors for the development of MM tears. An increase in the tibial slope, especially of the lateral plateau, seems to increase the risk of tear of the LM and of both menisci.

Level of evidence: Level III.

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Authors and Affiliations

  1. Laboratoire de Biomécanique et Mécanique des Chocs, Université Claude Bernard Lyon 1 – IFSTTAR, Villeurbanne, France

    Ashraf EL Mansori, Raphael Dumas & Sebastien Lustig

  2. Orthopaedic Surgery Department, Lyon Croix Rousse University Hospital, Lyon, France

    Ashraf EL Mansori, Antoine Schneider, Elvire Servien & Sebastien Lustig

  3. Melbourne Orthopaedic Group, Melbourne, Australia

    Timothy Lording

Authors
  1. Ashraf EL Mansori
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  2. Timothy Lording
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  3. Antoine Schneider
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  6. Sebastien Lustig
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Corresponding author

Correspondence to Sebastien Lustig.

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Conflict of interest

AE, TL, AS, and RD declare no conflict of interest. ES is the consultant for Smith & Nephew, institutional research support from Corin and Amplitude. SL is the consultant for Smith & Nephew, institutional research support from Corin and Amplitude.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Mansori, A.E., Lording, T., Schneider, A. et al. Incidence and patterns of meniscal tears accompanying the anterior cruciate ligament injury: possible local and generalized risk factors. International Orthopaedics (SICOT) 42, 2113–2121 (2018). https://doi.org/10.1007/s00264-018-3992-x

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  • DOI: https://doi.org/10.1007/s00264-018-3992-x

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