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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

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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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

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan

    Kengo Shimozaki, Junsuke Nakase, Takeshi Oshima, Kazuki Asai, Kazu Toyooka & Hiroyuki Tsuchiya

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  1. Kengo Shimozaki
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  2. Junsuke Nakase
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  3. Takeshi Oshima
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  4. Kazuki Asai
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Correspondence to Junsuke Nakase.

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The Ethical Committee of the Graduate School of our institution approved this study.

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All patients provided informed consent before participating in this study.

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Shimozaki, K., Nakase, J., Oshima, T. et al. Partial lateral meniscus anterior root injuries during anatomical single-bundle anterior cruciate ligament reconstruction are likely to occur in women with small skeletons. Knee Surg Sports Traumatol Arthrosc 28, 3517–3523 (2020). https://doi.org/10.1007/s00167-020-05896-8

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  • DOI: https://doi.org/10.1007/s00167-020-05896-8

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