Magnetic Resonance Imaging Evaluation of the Anterolateral Ligament in Acute Anterior Cruciate Ligament Injuries in an Adolescent Population

Camilo Partezani Helito; Paulo Victor Partezani Helito; Luiz Felipe Boulitreau Assirati; Carlos Henrique Longo; Marcelo Bordalo-Rodrigues; Felipe Ferreira de Souza

doi:10.1016/j.arthro.2019.02.034

Magnetic Resonance Imaging Evaluation of the Anterolateral Ligament in Acute Anterior Cruciate Ligament Injuries in an Adolescent Population

Arthroscopy. 2019 Jul;35(7):2136-2142. doi: 10.1016/j.arthro.2019.02.034.

Authors

Camilo Partezani Helito¹, Paulo Victor Partezani Helito², Luiz Felipe Boulitreau Assirati³, Carlos Henrique Longo³, Marcelo Bordalo-Rodrigues², Felipe Ferreira de Souza⁴

Affiliations

¹ Hospital Sírio-Libanês, São Paulo, Brazil; Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: camilo_helito@yahoo.com.br.
² Hospital Sírio-Libanês, São Paulo, Brazil; Grupo de Radiologia Musculo-esquelética, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
³ GRUPO DASA, São Paulo, Brazil.
⁴ University of Miami, Florida, U.S.A.

PMID: 31272633
DOI: 10.1016/j.arthro.2019.02.034

Abstract

Purpose: To evaluate the frequency of anterolateral ligament (ALL) injuries in acute anterior cruciate ligament (ACL) injuries in adolescent patients using magnetic resonance imaging (MRI) and characterize other potential intra- and extra-articular knee injuries that are associated with ALL injuries.

Methods: Patients between 14 and 17 years of age with acute ACL injuries (trauma for <3 weeks before examination) were retrospectively evaluated with MRI over 24 months (January 2016-December 2017). Among this population, ALL was classified as not visible, normal, or injured. Injuries were separated into strains (partial injuries), complete injuries, or Segond fractures. Possible abnormalities of the menisci, collateral ligaments, popliteal tendon, posterior cruciate ligament (PCL), iliotibial tract (ITT), and bone injuries were evaluated. Associations were calculated between ALL injuries and injuries of these other knee structures, as well as age and gender.

Results: ALL was visible in 171 of the 184 MRI-evaluated knees (92.9%). ALL was considered normal in 68 (39.8%) and damaged in 103 (60.2%) patients. ALL injuries were considered partial in 56 (54.4%) and total in 44 (42.7%) cases. Only 3 (2.9%) cases were Segond fractures. ALL injuries were associated with ITT (P < .0001), lateral meniscus (P = .04), lateral collateral ligament (P = .01), popliteal tendon (P = .001), and medial collateral ligament (P = .009) injuries, in addition to bone contusions in the lateral compartment of the knee (P < .0001). There was no correlation between ALL injuries and medial meniscus (P = .054) or PCL (P = .16) injuries.

Conclusions: MRI evaluation showed ALL injuries are present in 60.2% of acute ACL injuries in adolescent patients. These injuries are associated with the medial and lateral collateral ligaments, ITT, lateral meniscus injuries, and bone contusions, but they are not associated with medial meniscus or PCL injuries.

Level of evidence: Level IV, case series.

MeSH terms

Acute Disease
Adolescent
Anterior Cruciate Ligament Injuries / diagnosis*
Female
Humans
Knee Joint / diagnostic imaging
Magnetic Resonance Imaging / methods*
Male
Medial Collateral Ligament, Knee / diagnostic imaging*
Posterior Cruciate Ligament / diagnostic imaging*
Retrospective Studies
Rupture