Meniscal Lesions in Multi-Ligament Knee Injuries

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Knee Biomechanics

Background:

• Multi-ligament knee injuries (MLKIs) are complex and frequently associated with intra-articular damage, notably meniscal tears.
• Understanding meniscal tear patterns in MLKIs is vital for effective surgical treatment.

Purpose of the Study:

• To determine the incidence, classification, and treatment of meniscal injuries in MLKI patients.
• To conduct an updated review of existing evidence on meniscal injuries in MLKIs.

Main Methods:

• Retrospective study of 70 patients undergoing reconstructive surgery for MLKIs (2013-2023).
• Analysis of patient demographics, MRI, and operative reports, categorized by ligament injury patterns.
• Meniscal tears identified via MRI and arthroscopy; statistical analysis included Fisher's exact test and kappa agreement test.

Main Results:

• 67.1% of MLKI patients had meniscal lesions; anterior cruciate ligament (ACL) + medial collateral ligament/posteromedial corner (MCL/PMC) injuries were most common (52.86%).
• ACL + medial-side injuries showed a higher incidence of meniscal damage (78.38%), predominantly lateral meniscus tears.
• MRI showed good agreement with arthroscopy for meniscal tear detection (kappa 0.78-0.84).

Conclusions:

• Ligament injury patterns significantly influence meniscal damage incidence and location.
• ACL + medial-side injuries are associated with greater meniscal damage.
• High index of suspicion, quality MRI, and arthroscopic evaluation are essential for managing meniscal lesions in MLKIs.