Assessment of the Anterolateral Ligament of the Knee by Magnetic Resonance Imaging in Acute Injuries of the Anterior Cruciate Ligament.
OBJECTIVE
To evaluate the epidemiology of injuries and abnormalities of the anterolateral ligament (ALL) by magnetic resonance imaging (MRI) in cases of acute anterior cruciate ligament (ACL) injury.


METHODS
MRIs of patients with acute ACL injury were evaluated. Acute injuries of the ACL were considered in cases in which the patient reported knee trauma occurring less than 3 weeks prior and when bone bruise in the femoral condyles and tibial plateau was identified. ALL abnormality was considered when it showed proximal or distal bone detachment, discontinuity of fibers, or irregular contour associated with periligamentous edema. The ALL was divided into femoral, tibial, and meniscal portions, and the lesions and/or abnormalities of each portion were characterized. The correlation of ALL injury with injuries of the lateral meniscus was evaluated.


RESULTS
A total of 101 MRIs were initially evaluated. The ALL was not characterized in 13 (12.8%) examinations, resulting in 88 (87.1%) cases of injury evaluation. Of these, 55 (54.4%) patients had a normal ALL, and 33 (32.6%) showed signs of injury. Among the cases with injury, 24 (72%) patients showed proximal lesions, 7 (21%) showed distal lesions, and 2 (6.0%) patients presented both proximal and distal lesions. The meniscal portion of the ALL appeared abnormal in 16 (48%) patients. No relationship was found between ALL injury and lateral meniscus injury.


CONCLUSIONS
Based on MRI analysis of acute ACL injuries with bone bruising of the lateral femoral condyle and lateral tibial plateau, approximately a third demonstrated ALL injuries of which the majority was proximal.


METHODS
Level IV, case series.
Hospital Sírio-Libanês, São Paulo, Brazil; Knee Surgery Division, Faculty of Medicine, Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil. Electronic address: camilo_helito@yahoo.com.br.
Camilo Partezani
CP
Helito
Hospital Sírio-Libanês, São Paulo, Brazil; Musculoskeletal Radiology Department, Faculty of Medicine, Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil.
Paulo Victor Partezani
PVP
Helito
Hospital Sírio-Libanês, São Paulo, Brazil; Musculoskeletal Radiology Department, Faculty of Medicine, Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil.
Hugo Pereira
HP
Costa
Knee Surgery Division, Faculty of Medicine, Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil.
Marco Kawamura
MK
Demange
Hospital Sírio-Libanês, São Paulo, Brazil; Musculoskeletal Radiology Department, Faculty of Medicine, Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil.
Marcelo
M
Bordalo-Rodrigues
D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction; D001938:Brazil / Q000453:epidemiology; D017885:Collateral Ligaments / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male