2019 ISAKOS Biennial Congress ePoster #738
1.5 Tesla Magnetic Resonance Imaging Demonstrates a High Prevalence of Anterolateral Ligament Abnormalities in Acutely Anterior Cruciate Ligament Injured Knees: A Case-Control Series Comparing against the Contralateral Uninjured Knee from Santi Study Grou
Andrea Ferretti, Prof., Rome, RM ITALY
Edoardo Monaco, MD, Rome ITALY
Andrea Redler, Prof. MD PhD, Rome ITALY
Giuseppe Argento, MD, Rome ITALY
Angelo De Carli, MD, Rome ITALY
Adnan Saithna, MD, FRCS, Scottsdale, AZ UNITED STATES
Paulo Helito, MD, São Paulo, SP BRAZIL
Camilo P. Helito, MD, PhD, Prof, São Paulo, SP BRAZIL
Sant'andrea Hospital, Sapienza University of Rome, Rome, ITALY
FDA Status Not Applicable
Summary
This study use MRI to determine the prevalence and spectrum of abnormalities of the anterolateral structures in acute ACL injured knees using the contralateral un-injured knee as a reference
Abstract
Introduction
MRI is a frequently used modality for investigation of pathological changes in the extra-articular soft tissues of the knee, for which it demonstrates high sensitivity and specificity. However, the current literature shows a broad variability in the rate of MRI identification of the normal ALL and also the rate of injury (40-80%) in acutely ACL injured knees.The aim of this study was to use MRI to determine the prevalence and spectrum of abnormalities of the anterolateral structures in acute ACL injured knees using the contralateral un-injured knee as a reference.
Methods
Patients with acute ACL injury underwent MRI of both knees. Images were evaluated by three observers. Inter- and intra-observer reliability were determined for MRI parameters of ALL injury using Kappa test. Univariate and multivariate analyses were conducted to test associations between ALL abnormality and associated injuries.
Results
Thirty-four patients were evaluated. Thirty (88.2%) patients had at least one ALL abnormality in the ACL injured knee (increased signal, n=27 (79.4%); increased thickness, n=15(44.1%), tapering, n=7 (20.6%); irregularities in the path of the ALL fibers, n=21 (61.7%). Asymmetry of the genicular vessels (GV) were observed in 21 (61.7%) cases. ALL abnormality was significantly associated with lateral joint capsular tears (p <0.001). There was no correlation between ALL lesions and Iliotibial band (ITB) lesions (p = 0.49).
Conclusions
1.5T MRI evaluation of the ALL is associated with good and very good inter- and intra-observer reliability, and it demonstrates abnormalities of the ALL in the majority of acutely ACL injured knees. The index of suspicion of ALL injury should be elevated by the presence of lesions of the lateral capsule. This suggests that the ALL is a part of a wider area of the lateral capsule that is often injured simultaneously in an acute ACL tear.
This study shows that 1.5T MRI evaluation of the anterolateral structures in the acutely ACL injured knee is reliable. Good to very good inter- and intra-observer reliability were reported for observations of injury to the ALL.