Author Reply to Letters to the Editor From Sonnery-Cottet et al. and Ferretti

Williams, Andy

doi:10.1016/j.arthro.2018.05.015

Cited by 4 publications

(9 citation statements)

References 13 publications

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“…A number of authors have described visualizing hemorrhage in the region of the KFs during surgical exploration. 9,41,44 It has been postulated that injury to the superior lateral genicular vessels is responsible for this hemorrhage because of their proximity to the KFs. 10,44 However, these studies do not explicitly describe disruption to the continuity of the KF complex, nor do they correlate injury with rotatory laxity.…”

Section: Discussionmentioning

confidence: 99%

“…9,41,44 It has been postulated that injury to the superior lateral genicular vessels is responsible for this hemorrhage because of their proximity to the KFs. 10,44 However, these studies do not explicitly describe disruption to the continuity of the KF complex, nor do they correlate injury with rotatory laxity. 9,41,44 Therefore, it is crucial not to assume that the presence of hemorrhage or edema alone on MRI heralds serious structural damage to the lateral side of the knee.…”

Section: Discussionmentioning

confidence: 99%

“…11,22,23 However, there is limited information, aside from anecdotal reports and small studies, about how often the ITB and KFs are compromised in association with an ACL injury. 9,41,44 Recent radiological studies have shown that the KFs can be identified by use of standard knee magnetic resonance imaging (MRI) in the ACL-intact knee, 1 and there is emerging evidence that radiological evidence of KF injury can be seen in the setting of ACL injury. 24,42 However, it remains to be determined if and when KF injuries are clinically significant in terms of arthroscopic findings and assessment of rotatory laxity.…”

mentioning

confidence: 99%

“…11,22,23 However, there is limited information, aside from anecdotal reports and small studies, about how often the ITB and KFs are compromised in association with an ACL injury. 9,41,44…”

mentioning

confidence: 99%

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Association Between Radiological Evidence of Kaplan Fiber Injury, Intraoperative Findings, and Pivot-Shift Grade in the Setting of Acute Anterior Cruciate Ligament Injury

et al. 2021

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Background: Biomechanical studies have suggested that the Kaplan fibers (KFs) of the iliotibial band play a role in controlling anterolateral rotation of the knee. There is a paucity of clinical information on whether injury to the KF in the setting of anterior cruciate ligament (ACL) rupture contributes to increased rotatory laxity of the knee. Purpose/Hypothesis: The purpose was to evaluate the association among radiological evidence of KF injury, intraoperative arthroscopic findings, and grade of pivot shift at the time of ACL reconstruction (ACLR). It was hypothesized that KF injury would be associated with increased injury to the lateral compartment of the knee and a higher grade of pivot shift. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective magnetic resonance imaging (MRI) analysis was conducted on 267 patients with ACL-injured knees who underwent primary ACLR. Patients who had MRI and surgery within 60 days of injury were included (mean age, 23.6 years); there were 158 (59.2%) male patients. MRI was performed using standard knee protocols, and diagnostic criteria were applied to identify KF injury. Associations were made among MRI findings, intraoperative findings, and grade of pivot shift with the patient examined under anesthesia at the time of ACLR. A comparison was made between patients with and without radiological evidence of KF injury. Results: The prevalence of KF injury was 17.6% (47/267 patients). Arthroscopic evidence of lateral meniscal injury was associated with KF injury (KF intact, 31%; KF injured, 55%; P = .010). The majority of patients in the intact and injured KF groups had a grade 2 pivot shift (75% and 70%, respectively). A minority had grade 3 pivot shift: 5% in the intact group versus 6.4% in the injured group. There was no association between radiological evidence of KF injury and pivot-shift grade ( P = .600). Conclusion: In acute ACL injury, KF injuries were not very common (17.6%), and the rate of grade 3 pivot shift was low (5.2%). When present, KF injuries were not associated with a higher-grade pivot shift. However, there was an association between KF injury and lateral meniscal tears identified at the time of ACLR. The role of KFS in controlling anterolateral rotatory laxity in the acute ACL injury in the clinical setting may be less evident when compared with the biomechanical setting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…11,22,23 However, there is limited information, aside from anecdotal reports and small studies, about how often the ITB and KFs are compromised in association with an ACL injury. 9,41,44…”

mentioning

confidence: 99%

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Association Between Radiological Evidence of Kaplan Fiber Injury, Intraoperative Findings, and Pivot-Shift Grade in the Setting of Acute Anterior Cruciate Ligament Injury

et al. 2021

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“…Being cognizant of this, I am happy to agree to disagree while at the same time respecting the senior authors of the letters." 10 Rather than try to summarize the articles, commentary, letters, and reply, which are salient, scientific and quite interesting, we encourage interested readers to give the cited references additional consideration. Your editors greatly admire and appreciate the contributions of Ferretti, Sonnery-Cottet and coauthors, and Williams to our journal and our field.…”

Section: Knee Anterolateral Ligamentmentioning

confidence: 99%