Patterns of meniscal injury associated with acute anterior cruciate ligament injury in skiers

Paletta, George A.; Levine, David S.; O’Brien, Stephen J.; Wickiewicz, Thomas L.; Warren, Russell F.

doi:10.1177/036354659202000510

Cited by 74 publications

(54 citation statements)

References 37 publications

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“…In an acute ACL tear of the valgus, the rotational force compressing the lateral compartment makes lateral meniscal tears more common [4,10,14]. The injury triad of ACL-MCL-lateral meniscus appeared twice as often as the ACL-MCL-medial meniscus combination.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

Halinen

Koivikko

Lindahl

et al. 2008

International Orthopaedics (SICOT)

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This study compares MRI with examination under anaesthesia to surgical findings in evaluating soft tissue injuries in acute multi-ligament knee trauma. Preoperative MRI was done for 44 patients who underwent surgery for grade III ACL and grade III medial collateral ligament (MCL) injury. In 21 cases both ACL and MCL were treated surgically, but in 23 only ACL. Intra-operative and MRI findings were compared. Accuracy of MRI for medial meniscal tears was 88.6%, sensitivity 80%, and specificity 91.2%; accuracy for lateral meniscal tears was 72.7%, sensitivity 55% and specificity 87.5%. Accuracy and sensitivity for severity of ACL tear was 93.2% and of MCL tear 86.4%. In 88.6% of the knees, bone bruises were visible, with anterolateral femoral and posterolateral tibial bone bruise being the most common. MRI revealed no chondral lesion, but arthroscopy revealed 11. In combined ACL-MCL ruptures, the incidence of concomitant injuries is high and the injuries are best detected with MRI.

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Section: Discussionmentioning

confidence: 99%

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

Halinen

Koivikko

Lindahl

et al. 2008

International Orthopaedics (SICOT)

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“…Although other authors have found a somewhat lower incidence of horizontal tears, most agree that this type of tear constitutes a significant portion of degenerative tears of the meniscus (1 1, 13,17,26,27,37). Although radial fiber sheets are thought to prevent traumatic longitudinal tears in the meniscus (4,8,9), they actually may predispose the meniscus to horizontal tears.…”

Section: Figmentioning

confidence: 98%

Radial tie fibers influence the tensile properties of the bovine medial meniscus

Skaggs¹,

Warden²,

Mow³

1994

Journal Orthopaedic Research

145

116

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Although collagen fibers are arranged predominantly in the circumferential direction in the knee meniscus, there is evidence for radially oriented fibers within human menisci. A bovine medial meniscus model was used to study the hypothesis that radial fibers alter the radial tensile properties of the meniscus. The architecture of the collagen network and tensile properties of the bovine medial meniscus were examined; attention was given to large "radial tie fibers" and their regional variation. Menisci were sectioned serially into slices 400 microns thick. Polarized light microscopy showed that the distribution of radial tie fibers varied greatly among the anterior, central, and posterior regions. These radial tie fibers were larger and more frequent in the posterior region. Radial fibers persisted over many adjacent sections with similar architecture, which led to our hypothesis that they may be arranged in continuous sheets in which the morphology varies by region. Radially oriented specimens for tensile testing were grouped according to the number of radial tie fibers (full, partial, and no fiber) and region (anterior, central, and posterior). Uniaxial tensile testing was performed on a testing machine at a strain rate of 0.00017 sec-1 until failure. The tensile modulus, ultimate tensile stress, and ultimate tensile strain were determined. The presence of radial tie fibers in the specimen had a significant effect on the tensile modulus and ultimate tensile stress. Specimens containing full radial tie fibers were stiffest and failed at the lowest strains; in specimens from the posterior region, the tensile modulus was 392%, the ultimate tensile stress was 314%, and the ultimate tensile strain was 68% that of the specimens with no radial fibers. In no-fiber specimens, the tensile modulus in the posterior region was 225% of the modulus in the anterior region, and the ultimate tensile strain in the posterior region was 68% that of the strain in the anterior region. The abundance of radial tie fibers in the posterior region seems to contribute to the increased stiffness of this region. The preferential stiffening of the posterior region by these radial fibrous sheets may be well suited to the manner in which the bovine medial meniscus functions in load-bearing.

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“…This finding regarding the torsion release is of great importance because it is known that in both, recreational as well as competitive skiing, the largest number of injuries is related to the lower extremities, particularly to the knee joint [12][13][14]. For the knee joint it was found that both, internal and external rotations of the ski, are associated with knee injury mechanisms [22][23][24].…”

Section: Discussionmentioning

confidence: 96%

Special Design of Ski Plates May Improve Skiing Safety

Supej

Senner

2017

Snow Sports Trauma and Safety

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Background: Alpine skiing is a popular winter sport that is confronted with high injury rates. Ski bindings are often mounted on ski plates, which can positively affect the release consistency of ski bindings and thus improve skiing safety. The aim of the study was to explore, if a new ski plate design of which the middle main part was "floating" on rocker arms improved the release consistency of ski bindings when the ski was deflected.Method: In order to test the new ski plate, three pairs of equal slalom skis were equipped with identical ski bindings. They were mounted: (1) directly to the ski, (2) on the original ski plate, and (3) on the new ski plate. The forward bending release and the torsion release behaviour of these three ski-plate-binding set-ups were tested on a standardized testing device under three conditions: a flat ski, skideflection according to the ISO-standard and an extreme ski-deflection.Results: One-way ANOVA with Tukey post hoc test revealed that all comparisons among different mountings of the binding under three conditions, except in three occurrences when comparing no plate versus new plate, were significantly different. In addition, the new ski plate demonstrated a more consistent torsion release behaviour with almost no shift in the release load (~ −1.5%) for both tested ski-deflections. The majority of relative differences ranged between 6.9 and 8.2% between the three tested mounting conditions with respect to the forward release.Conclusion: Mounting ski bindings on specially designed ski plates may result in an improved release behaviour and thus potentially increase skiing safety.

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Patterns of meniscal injury associated with acute anterior cruciate ligament injury in skiers

Cited by 74 publications

References 37 publications

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

Radial tie fibers influence the tensile properties of the bovine medial meniscus

Special Design of Ski Plates May Improve Skiing Safety

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