gms | German Medical Science

German Congress of Orthopaedics and Traumatology (DKOU 2021)

26. - 29.10.2021, Berlin

Article

Send article

Injuries to the Anterolateral Ligament are observed more frequently compared to lesions to the Deep Iliotibial Tract (Kaplan Fibers) in Anterior Cruciate Ligamant deficient Knees using Magnet Resonance Imaging (MRI)

Meeting Abstract

Search Medline for

  • presenting/speaker Armin Runer - Universitätsklinik für Orthopädie und Traumatologie, Innsbruck, Austria
  • Dietmar Dammerer - Universitätsklinik für Orthopädie und Traumatologie, Innsbruck, Austria
  • Christoph Kranewitter - Abteilung für Radiologie, MUI Innsbruck, Innsbruck, Austria
  • Benjamin Henninger - Abteilung für Radiologie, MUI Innsbruck, Innsbruck, Austria
  • Johannes Giesinger - Medizinische Universität Innsbruck, Innsbruck, Austria
  • Michael Hirschmann - Klinik für Orthopädie und Traumatologie, Bruderholz, Germany
  • Michael Liebensteiner - Univesitätsklinik für Orthopädie und Traumatologie, Innsbruck, Austria

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2021). Berlin, 26.-29.10.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocAB30-511

doi: 10.3205/21dkou122, urn:nbn:de:0183-21dkou1222

Published: October 26, 2021

© 2021 Runer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objectives: To determine the accuracy of detection, injury rate and inter- and intrarater reproducibility in visualizing lesions to the anterolateral ligament (ALL) and the deep portion of the iliotibial tract (dITT) in anterior cruciate ligament (ACL) deficient knees of adult- and pediatric patients.

Methods: Ninety-one consecutive patients, out of those 25 pediatrics, with diagnosed ACL tears were included. Two musculoskeletal radiologists blinded to the clinical findings of the patient, retrospectively reviewed MRI data focusing on accuracy of detection and potential injuries to the ALL or dITT. Lesion were diagnosed in case of discontinued fibers in combination with intra- or peri-ligamentous edema and graded as intact, partial or complete tears. Cohen's Kappa and 95% confidence intervals (95% CI) were determined for inter- and intrarater reliability measures. The following scale of measurement agreement was applied: 0 - 0.2, slight; 0.21 - 0.4, fair; 041 - 0.6, moderate; 0.61 - 0.8, substantial; 0.81 - 1, almost perfect.

Results: The ALL and dITT were visible in 52 (78.8%) and 56 (84.8%) of adult- and 25 (100%) and 19 (76.0%) of pediatric patients, respectively.

The ALL was injured in 45 (58.5%; partial: 36.4%, compleate: 22.1%) patients. Partial and comleate tears where visualized in 21 (40.4%) and 16 (30.8%) adult- and seven (28.0%) and one (4%) peditric patients.

A total of 16 (21.3%; partial: 13.3%, compleate: 8.0%) dITT injuries were identified. Partal and complete lesions were seen in seven (12.5%) and five (8.9%) adult- and three (15.8%) and one (5.3%) pediatric patients. Combined injuries were visualized in nine (12.7%) patients. Inter-observer (0.91 - 0.95) and intra-observer (0.93 - 0.95) reproducibility was high.

Conclusion: In ACL injured knees, tears of the ALL are observed more frequently compared to lesions to the deep iliotibial tract. Combined injuries of both structures are rare.

Clinically, the preoperative visualization of potentially injured structures of the anterolateral knee is crucial and is important for a more personalized preoperative planning and tailored anatomical reconstruction. The clinical implication of injuries to the anterolateral complex of the knee needs further investigation.