2015 ISAKOS Biennial Congress ePoster #1352
Contact vs. Non-Contact ACL Injuries: Is Mechanism of Injury Predictive of Concomitant Knee Pathology?
Daniel Woods, MD, Philadelphia, PA UNITED STATES
Matthew Stein, Villanova, PA UNITED STATES
Adam Reese, BS, Philadelphia, PA UNITED STATES
Steven B. Cohen, MD, Media, PA UNITED STATES
Robert Frederick, MD, Villanova, PA UNITED STATES
Kevin Freedman, MD, Bryn Mawr, PA UNITED STATES
Michael G. Ciccotti, MD, Philadelphia, PA UNITED STATES
Kevin Lawson, MD, Philadelphia, PA UNITED STATES
The Rothman Institute of Orthopaedics at Thomas Jefferson University, Phialdelphia, PA, USA
FDA Status Not Applicable
Summary: Evaluation of contact and non-contact anterior cruciate ligament (ACL) injuries found that patients who incur a contact mechanism of ACL injury are more likely to have concomitant articular cartilage damage and collateral ligament injury than those who have a non-contact mechanism.
Two main mechanisms of injury to the anterior cruciate ligament (ACL) have been described: contact and non-contact. Additionally, ACL injuries are often complicated by concomitant damage to articular cartilage, menisci, and collateral ligaments. The purpose of this study was to evaluate if the mechanism of ACL injury is predictive of associated damage found at the time of ACL reconstruction.
Contact ACL injuries will have a higher rate of meniscal, articular cartilage, and collateral ligament injuries when compared to non-contact injuries.
All patients who underwent ACL reconstructions from January, 2009 through April, 2014 between ages 16 and 40 were enrolled. Mechanism of injury was provided from the patient’s history. The presence of concomitant injuries to the knee, including meniscal (medial and lateral), articular cartilage (Grade III-Grade IV outerbridge injuries) and collateral ligaments (MCL, LCL or PLC) were reviewed from both MRI findings and operative records.
150 ACL injuries were included with 35 contact injuries and 135 non-contact injuries. Both cartilage injuries (p=0.0023; odds ratio 6.41) and collateral ligament injuries (p=0.0119; odds ratio 3.20) were found to be significantly more common in patients with a contact ACL injury versus a non-contact ACL injury. Injuries to the meniscus (medial, lateral, or combined) did not occur at a higher rate following contact injuries compared to non-contact injuries.
Patients who incur a contact mechanism of ACL injury are more likely to have concomitant articular cartilage damage and collateral ligament injury than those who have a non-contact mechanism. Mechanism of injury does not predict the occurrence of concomitant meniscal pathology.
Clinical Relevance: Predicting a higher rate of articular cartilage and collateral ligament damage from contact ACL injuries may aid in patient counseling and pre-operative planning. Further studies are necessary to determine if this increased risk of concomitant damage for a contact mechanism portends a worse ultimate outcome after ACL reconstruction.