Background: There is biomechanical evidence of the contribution of meniscal tears on knee stability when anterior cruciate ligament (ACL) is torn. However, clinical studies on this topic remain limited, and the conclusions derived from existing research are still incomplete. This study aims to clinically evaluate the impact of medial and lateral meniscus tears on anteroposterior laxity and the pivot-shift phenomenon in a cohort of patients with ACL-deficient knees. Methods: A retrospective analysis was conducted on 306 ACL-deficient patients, which were categorized into 4 groups: 1) isolated ACL injury, 2) ACL injury with medial meniscus tears (ACL + MM), 3) ACL injury with lateral meniscus tears (ACL + LM), 4) ACL injury with combined medial and lateral meniscus tears (ACL + MM + LM). Statistical comparison was performed regarding demographic characteristics, sport activity level, time from injury to treatment, prevalence of high-grade Lachman test, prevalence of high-grade pivot-shifts and KT1000 arthrometric measurements. Statistical significance was set at p < 0.05. Results: Associated meniscal tears were observed in 202 out of 306 cases (66.0 %). Patients in ACL + MM group presented significant higher age, body mass index, longer time from injury, and lower activity level compared to those with isolated ACL tears. Patients in the ACL + MM group showed higher KT1000 values (5.5 ± 1.3 mm) when compared to isolated tears (4.9 ± 1.2 mm, p = 0.0012), but not significant difference in rates of high-grade pivot shift grade. Patients in the ACL + LM group demonstrated significantly increased rates of high-grade pivot-shift grade (p < 0.0001), but no significant differences in KT1000 values. Patients in the ACL + MM + LM group showed increased rates of pivot shift grade ≥2 (p = 0.0003) and significantly increased KT1000 values (6.1 ± 1.9 mm) compared to isolated ACL tears (p < 0.0001) but also compared to ACL + MM patients (p = 0.0153) and ACL + LM patients (p = 0.0030). Conclusions: Concomitant meniscus tears in ACL-deficient knees significantly increase anterior tibial translation and rotational joint laxity, suggesting a secondary but significant role in knee stability. Level of evidence: IV, retrospective case series.
The impact of meniscal tears on anterior tibial translation and rotatory instability in anterior cruciate ligament-deficient knees: Retrospective analysis of 306 cases
Russo, Arcangelo;Lo Giudice, Emilia;Pegreffi, Francesco;Francavilla, Vincenzo Cristian
2025-01-01
Abstract
Background: There is biomechanical evidence of the contribution of meniscal tears on knee stability when anterior cruciate ligament (ACL) is torn. However, clinical studies on this topic remain limited, and the conclusions derived from existing research are still incomplete. This study aims to clinically evaluate the impact of medial and lateral meniscus tears on anteroposterior laxity and the pivot-shift phenomenon in a cohort of patients with ACL-deficient knees. Methods: A retrospective analysis was conducted on 306 ACL-deficient patients, which were categorized into 4 groups: 1) isolated ACL injury, 2) ACL injury with medial meniscus tears (ACL + MM), 3) ACL injury with lateral meniscus tears (ACL + LM), 4) ACL injury with combined medial and lateral meniscus tears (ACL + MM + LM). Statistical comparison was performed regarding demographic characteristics, sport activity level, time from injury to treatment, prevalence of high-grade Lachman test, prevalence of high-grade pivot-shifts and KT1000 arthrometric measurements. Statistical significance was set at p < 0.05. Results: Associated meniscal tears were observed in 202 out of 306 cases (66.0 %). Patients in ACL + MM group presented significant higher age, body mass index, longer time from injury, and lower activity level compared to those with isolated ACL tears. Patients in the ACL + MM group showed higher KT1000 values (5.5 ± 1.3 mm) when compared to isolated tears (4.9 ± 1.2 mm, p = 0.0012), but not significant difference in rates of high-grade pivot shift grade. Patients in the ACL + LM group demonstrated significantly increased rates of high-grade pivot-shift grade (p < 0.0001), but no significant differences in KT1000 values. Patients in the ACL + MM + LM group showed increased rates of pivot shift grade ≥2 (p = 0.0003) and significantly increased KT1000 values (6.1 ± 1.9 mm) compared to isolated ACL tears (p < 0.0001) but also compared to ACL + MM patients (p = 0.0153) and ACL + LM patients (p = 0.0030). Conclusions: Concomitant meniscus tears in ACL-deficient knees significantly increase anterior tibial translation and rotational joint laxity, suggesting a secondary but significant role in knee stability. Level of evidence: IV, retrospective case series.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
