ACL injuries combined with lateral and medial knee injuries acute versus chronic injury: What to do

Abstract

Acute anterior cruciate ligament (ACL) tears can occur as isolated injuries but more commonly occur in conjunction with injuries to the other structures of the knee, including the knee ligaments and the menisci. Isolated tears of the ACL have a better prognosis following surgical reconstruction, while ACL tears that are combined with damage to the medial and/or lateral structures of the knee have been reported to lead to decreased knee stability and place patients at an increased risk of developing osteoarthritis [2]. Oiestad et al. reported patients with combined ACL injuries to have a signi fi cantly increased prevalence of knee OA on plain radiographs compared to patients with an isolated ACL tear (80 vs. 62 %) [48]. It is critical to rule out medial and lateral knee ligament injuries when a patient presents with a torn ACL. Failing to adequately address medial or posterolateral knee injuries prior to reconstructing a de fi cient ACL has been reported to lead to the ACL reconstruction graft stretching out and/or failure due to increased forces on the reconstructed ligament [23, 41].