Simultaneous Rupture of the Anterior Cruciate Ligament, Medial Collateral Ligament and Patellar Tendon: A Case Series, Review of the Literature, and Proposed Treatment Algorithm

R, Apkarian Marc

doi:10.23937/2469-5718/1510144

Int J Sports Exerc Med

2019

DOI: 10.23937/2469-5718/1510144

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Simultaneous Rupture of the Anterior Cruciate Ligament, Medial Collateral Ligament and Patellar Tendon: A Case Series, Review of the Literature, and Proposed Treatment Algorithm

Apkarian Marc R¹

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2024

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Cited by 2 publications

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Simultaneous patellar tendon and anterior cruciate ligament rupture: a systematic review, meta-analysis and algorithmic approach

Ismailidis,

Neopoulos,

Egloff

et al. 2024

Arch Orthop Trauma Surg

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Introduction Isolated patellar tendon (PT) or anterior cruciate ligament (ACL) ruptures are common injuries, yet the co-occurrence of both presents a rare challenge for clinicians. The objectives of the study are to document diagnostic and therapeutic approaches, outcomes, and complications of combined PT and ACL injuries and to develop an algorithm to guide clinicians in decision-making. Methods The systematic review und metanalysis was conducted according to the PRISMA guidelines. Studies reporting on simultaneous PT and ACL ruptures were included. Meta-analysis was performed to compare different diagnostic modalities and treatment strategies. Results Thirty-six studies reporting on 56 Patients were included. 88% of patients had a concomitant injury (apart from PT and ACL) to the ipsilateral knee. Part of the diagnosis was missed in 23% of the cases. Performance of MRI significantly reduced the risk of missing a part of the injury (5% with MRI vs 69% without MRI, p < 0.001). Surgical treatment was used only for the PT in 21% of the cases and for the PT and ACL in 77% of the cases (48% one-stage, 52% two-stage surgical treatment). Conclusion Combined ACL and PT rupture is rare, and recognizing its full extent is crucial for successful management. Performing an MRI in PT rupture from high-energy trauma and diagnostic arthroscopy/arthrotomy when MRI is not done is essential. PT ruptures should be treated surgically. For ACL rupture, conservative and operative treatment, one- or two-stage surgery are possible based on the patient's profile and concomitant injuries. Based on the limited available literature, this systematic review provides a diagnostic and therapeutic algorithm to assist in clinical decision-making.

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Simultaneous patellar tendon and anterior cruciate ligament rupture: a systematic review, meta-analysis and algorithmic approach

Ismailidis,

Neopoulos,

Egloff

et al. 2024

Arch Orthop Trauma Surg

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Social deprivation index affects time to MRI after knee injury in pediatric patients and is predicted by patient demographics

Nacier,

Vutescu,

Bergen

et al. 2024

The Physician and Sportsmedicine

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Simultaneous Rupture of the Anterior Cruciate Ligament, Medial Collateral Ligament and Patellar Tendon: A Case Series, Review of the Literature, and Proposed Treatment Algorithm

Cited by 2 publications

References 20 publications

Simultaneous patellar tendon and anterior cruciate ligament rupture: a systematic review, meta-analysis and algorithmic approach

Simultaneous patellar tendon and anterior cruciate ligament rupture: a systematic review, meta-analysis and algorithmic approach

Social deprivation index affects time to MRI after knee injury in pediatric patients and is predicted by patient demographics

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