Anterior Cruciate Ligament Injuries: Patterns of Association Between the Mechanism of Injury and Spectrum of Intraarticular Knee Lesions

Abstract

ACL injuries are extremely common in young active population and have significant socio-economic impact.1 Though different mechanisms leading to ACL injuries have been described in the literature,2 the association between these mechanisms and the spectrum of associated meniscal, chondral, ligamentous and bony lesions have not been highlighted. This cross sectional study attempts to give an insight to the different mechanisms of ACL injury in 353 patients (aged 15-50 years) who underwent arthroscopic ACL reconstruction, and shows its association to the spectrum of lesions seen during arthroscopy and MR imaging. We found that “Solid foot plant with rotation of the knee” (46.5%), had a significant association with ACL injuries (p<0.001). Associated Medial meniscal injuries (75%) were the most common, followed by chondral damage (54%), lateral meniscus (33%), LCL(29%) and MCL(10.5%). The mechanism of “Solid foot plant with rotation of the knee” was associated to concomitant medial meniscal injury and “Solid foot plant with valgus stress on the knee “was associated to concomitant lateral meniscal injury (χ² 17.98; p<0.003, χ² 47.51; p<0.001). LCL, MCL and bone contusions also had significant association with the mechanism of Solid foot plant with valgus stress on the knee (p<0.001). We suggest the need to highlight these injury patterns and to focus on plyometric training to reduce ACL & associated injuries.3