CASE PRESENTATION –
abstractPosterolateral
knee instability in patients with anterior cruciate ligament lesion -
clinical and MRI evaluation Ion Bogdan Codorean1, Ioan Codorean 2, Stefan Mitulescu1, Eduard Cernat1 1Clinica de Ortopedie-Traumatologie Spitalul Universitar de Urgenta Militar Central, 2Centrul Medical Medas,Unitatea de Rezonanta Magnetica, Bucharest, Romania
Abstract
This paper
is a retrospective study between January 2007 - September 2012, and
refers to a group of 1347 patients with acute or old traumatic
injury, with instability of the knee (anteroposterior or
combined) and Magnetic Resonance Imaging (MRI) examination showed
isolated or associated lesions of anterior cruciate
ligament (ACL). Out of 1347 patients a group of 117 (8.6%)
patients was selected, in whom MRI examination revealed associated
lesions to the stability structures from the postero-lateral
compartment. The paper is showing the spectrum of lesions identified by
MRI in the postero-lateral compartment and their correlation with
the mechanism of injury and the data from the clinical exam and
the special tests for the clinical assessment of rotational
instability. The study will present statistics on identified
injuries and their MRI images. The highest incidence of lesions that
have generated rotational instability included the popliteal
anatomical complex formed by the popliteofibular ligament,
postero-lateral capsule, arcuate ligament, fabelofibular
ligament, fibular collateral ligament, biceps femoris tendon and
lateral gastrocnemius tendon. To be able to give fast and accurate
diagnostic information to the surgeon, with therapeutic significance,
to confirm or rule out the clinical diagnostic of
posterolateral rotational instability requires a good knowledge of the
anatomy of the posterolateral compartment being known the vast
anatomical variation and the small dimension of these structures.
Not being able to recognise and treat the posterolateral
compartment lesions contribute to ACL reconstruction failure due to
significantly increased forces that will stress the graft with varus
loading at various degrees of flexion.
Key
words:knee instability, traumatic injury, Magnetic Resonance Imaging
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