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Steep posterior lateral tibial slope, bone contusion on lateral compartments and combined medial collateral ligament injury are associated with the increased risk of lateral meniscal tear

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To determine the risk factors for lateral meniscus and root tears in patients with acute anterior cruciate ligament (ACL) injuries.

Methods

A total of 226 patients undergoing acute ACL reconstruction were included in the study sample. Exclusion criteria were revisions, fractures, chronic cases, and multiple ligament injuries, with the exception of medial collateral ligament (MCL) injuries. The patients were divided into groups based on the presence of lateral meniscus and root tears by arthroscopy. Binary logistic regression was used to analyze risk factors including age, sex, body mass index (BMI), injury mechanism (contact/non-contact), Segond fracture, side-to-side laxity, location of bone contusion, medial and lateral tibial and meniscal slope, mechanical axis angle, and grade of pivot shift.

Results

Overall lateral meniscus (LM) tears were identified in 97 patients (42.9%), and LM root tears were found in 22 patients (9.7%). The risk of an LM tear in ACL-injured knees increased with bone contusion on LTP (odds ratio [OR], 3.5; 95% confidence interval [CI] 1.419–8.634; P = 0.007), steeper lateral tibial slope (OR, 1.133; 95% CI 1.003–1.28; P = 0.045), MCL injury (OR, 2.618; 95% CI 1.444–4.746; P = 0.002), and non-contact injury mechanism (OR, 3.132; 95% CI 1.446–6.785; P = 0.004) in logistic regression analysis. The risk of LM root tear in ACL-injured knees increased with high-grade pivot shift (OR, 9.127; 95% CI 2.821–29.525; P = 0.000) and steeper lateral tibial slope (OR, 1.293; 95% CI 1.061–1.576; P = 0.011).

Conclusion

The increased risk of LM lesions in acute ACL-injured knees should be considered if significant risk factors including bone contusion on lateral compartments, MCL injury, and a steeper lateral tibial slope are present. Moreover, high-grade rotational injury with steeper lateral tibial slope are also significant risk factors for LM root tears, and therefore care should be taken by clinicians not to miss such lesions.

Level of evidence

III.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Korea

    Jeung-Hwan Seo, Dae-An Kim, Joong-Won Lee, Kang-Il Kim & Sang Hak Lee

  2. Department of Orthopedic Surgery, Hyundae General Hospital, Chung-Ang Univ., Namyangju-Si, Kyunggi-Do, Korea

    Seong Hwan Kim

  3. Department of Orthopedic Surgery, Chung-Ang University Hospital, 102, Heukseok-ro, Dongjak-gu, Seoul, Korea

    Seong Hwan Kim

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  1. Seong Hwan Kim
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Correspondence to Sang Hak Lee.

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This is approved by the institutional review board of Kyung Hee University Hospital at Gangdong (Institutional Review Board/protocol number, KHNMC2019-08-003.)

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Kim, S., Seo, JH., Kim, DA. et al. Steep posterior lateral tibial slope, bone contusion on lateral compartments and combined medial collateral ligament injury are associated with the increased risk of lateral meniscal tear. Knee Surg Sports Traumatol Arthrosc 30, 298–308 (2022). https://doi.org/10.1007/s00167-021-06504-z

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  • DOI: https://doi.org/10.1007/s00167-021-06504-z

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