title: Combined posterolateral corner and acute anterior cruciate ligament injuries in an adolescent cohort: a magnetic resonance imaging analysis.
abstract: OBJECTIVE
  Failure of a reconstructed anterior cruciate ligament (ACL) has significant morbidity in the paediatric and adolescent patient population. Untreated concomitant posterolateral corner (PLC) injury is an identified cause of failed ACL reconstruction; however, the injury pattern has yet to be defined for the paediatric population.
  
  
  METHODS
  Magnetic resonance imaging (MRI) studies of the knee performed between 1 January 2009 and 1 January 2013 were retrospectively reviewed. Imaging reports indicating an intra-substance injury of the ACL were reviewed, and all associated injured structures were recorded. Injury patterns were categorised by age, gender, physis status and associated injuries. Logistic regression and chi-square analyses compared ACL disruptions with and without concomitant PLC injuries.
  
  
  RESULTS
  One hundred and twenty-eight patients (74 boys and 54 girls, average age 15.27 years) sustained an ACL disruption. Concomitant injury to the PLC was seen in 13.3% of injuries. Associated PLC injuries were significantly associated with lateral meniscus injury and Segond fractures. Lateral meniscus injury was predictive of PLC injury (p = 0.05) upon logistic regression analysis.
  
  
  CONCLUSIONS
  Concomitant PLC injuries were found in 13.3% of all ACL disruptions on MRI analysis. Lateral meniscus injuries associated with an ACL disruption were predictive of concomitant PLC injury. Combined injury of the ACL and lateral meniscus should prompt close scrutiny to PLC structures.
authors.affiliation: Department of Orthopaedic Surgery, Dwight D. Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA, 30905, USA. shaw.aaron82@gmail.com.
authors.forename: Kenneth Aaron
authors.initials: KA
authors.lastname: Shaw
authors.affiliation: Department of Radiology, Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Dunoski
authors.affiliation: Department of Radiology, Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Mardis
authors.affiliation: Division of Orthopaedic Surgery, Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Pacicca
mesh_terms: D000293:Adolescent; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods; D002648:Child; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000473:pathology* / Q000601:surgery; D007719:Knee Joint / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012189:Retrospective Studies
keywords: Anterior cruciate ligament; Magnetic resonance imaging; Posterolateral corner