Partial lateral meniscus anterior root injuries during anatomical single-bundle anterior cruciate ligament reconstructio
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Partial lateral meniscus anterior root injuries during anatomical single‑bundle anterior cruciate ligament reconstruction are likely to occur in women with small skeletons Kengo Shimozaki1 · Junsuke Nakase1 · Takeshi Oshima1 · Kazuki Asai1 · Kazu Toyooka1 · Hiroyuki Tsuchiya1 Received: 17 June 2019 / Accepted: 31 January 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose This study aimed to investigate the occurrence and characteristics of lateral meniscus anterior root injuries during anatomical single-bundle anterior cruciate ligament (ACL) reconstruction. Methods Between 2011 and 2018, 70 women who had ACL injuries without lateral meniscal tears underwent anatomical single-bundle ACL reconstruction. Using computed tomography, the anatomical relationship between the predicted lateral meniscus anterior root insertion and the tibial tunnel was retrospectively assessed, and the patients were divided into partial lateral meniscus anterior root injury and intact groups. The demographic characteristics, the distances between bony landmarks, the tibial tunnel sizes, and lateral meniscal extrusion assessed by magnetic resonance imaging were compared between the two groups. Results Thirteen of the 70 patients had suspected partial lateral meniscus anterior root injuries. Patient height was significantly shorter in the injury group than in the intact group (157.7 ± 6.4 vs. 161.4 ± 5.4 cm: p = 0.03); the distance from the apex to the bottom of the slope of the medial intercondylar ridge was significantly shorter in the injury group than in the intact group (15.1 ± 1.9 vs. 16.7 ± 1.4 mm: p = 0.001). Conclusions Partial lateral meniscus anterior root injury during anatomical single-bundle ACL reconstruction was suspected in 18% of cases. Patient height and the distance between bony landmarks were significantly shorter in the injury group than in the intact group. Surgeons should understand that even a slight deviation of the tibial tunnel position can lead to partial lateral meniscus anterior root injury in patients with small skeletons. Level of evidence IV. Keywords Anterior cruciate ligament reconstruction · Anterior root of lateral meniscus injury · Lateral meniscal extrusion · Medial intercondylar ridge Abbreviations ACL Anterior cruciate ligament LMAR Lateral meniscus anterior root CT Computed tomography MRI Magnetic resonance imaging SMIR Slope of the medial intercondylar ridge BMI Body mass index ICC Interclass correlation coefficient RTD Reference point-to-tibial tunnel distance * Junsuke Nakase [email protected] 1
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13‑1 Takara‑machi, Kanazawa‑shi, Ishikawa‑ken 920‑8641, Japan
Introduction In anterior cruciate ligament (ACL) reconstruction, there is a consensus to create the femoral and tibial tunnels within the anatomical insertion area of the ACL to obtain good clinical results [1, 21]. Regarding the tibial tunnel, some anatomical studies ha
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