Lachlan M Batty1, Jerome Murgier1,2, Julian A Feller1,3, Richard O'Sullivan4,5, Kate E Webster3, Brian M Devitt1,3. 1. OrthoSport Victoria Research Unit, Richmond, Australia. 2. Aguilera Private Clinic, Ramsey Santé, Orthopedic Department, Biarritz, France. 3. School of Allied Health, La Trobe University, Melbourne, Australia. 4. Healthcare Imaging Services, Richmond, Australia. 5. Department of Medicine, Monash University, The Alfred Hospital, Melbourne, Australia.
Abstract
BACKGROUND: Recent biomechanical studies have demonstrated that the Kaplan fibers (KFs) of the iliotibial band play a role in the control of anterolateral rotation of the knee. However, controversy exists regarding whether the KFs are injured in conjunction with anterior cruciate ligament (ACL) injury. PURPOSE: To establish the prevalence of radiological injury to the KFs in the ACL-injured knee; to evaluate the effect of the time interval between injury and magnetic resonance imaging (MRI) on diagnosis of KF injury; and to assess for any association between KF injury and other qualitative radiological findings. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHODS: Preoperative MRI scans were reviewed for 161 patients with ACL injury. Specific diagnostic criteria were developed and applied to identify KF injury. Chi-square testing was performed to look for associations among KF injury, the time from injury to MRI, and associated radiological knee injuries. RESULTS: Radiological evidence of KF injury was identified in 30 (18.6%) patients. The diagnosis of KF injury was higher in patients who had MRI scans performed within 90 days of injury as compared with ≥90 days after injury (23.7 vs 6.4%; P = .010). Patients with an MRI diagnosis of KF injury had significantly higher rates of lateral meniscal injury (40% vs 18%; P = .007), posteromedial tibial bone marrow edema (73% vs 44%; P = .003), and injury to the lateral collateral ligament (13% vs 3%; P = .019) or medial collateral ligament (23% vs 8%; P = .019). CONCLUSION: The prevalence of injury to the KF in patients with ACL injury as diagnosed by MRI was relatively low (18.6% of patients). However, the time interval from injury to MRI was relevant to diagnosis, with significantly higher rates of injury identification in patients with early (within 90 days) versus delayed (≥90 days) MRI. KF injury was associated with higher rates of injury to the lateral meniscal and collateral ligaments, as well as posteromedial tibial bone bruising.
BACKGROUND: Recent biomechanical studies have demonstrated that the Kaplan fibers (KFs) of the iliotibial band play a role in the control of anterolateral rotation of the knee. However, controversy exists regarding whether the KFs are injured in conjunction with anterior cruciate ligament (ACL) injury. PURPOSE: To establish the prevalence of radiological injury to the KFs in the ACL-injured knee; to evaluate the effect of the time interval between injury and magnetic resonance imaging (MRI) on diagnosis of KF injury; and to assess for any association between KF injury and other qualitative radiological findings. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHODS: Preoperative MRI scans were reviewed for 161 patients with ACL injury. Specific diagnostic criteria were developed and applied to identify KF injury. Chi-square testing was performed to look for associations among KF injury, the time from injury to MRI, and associated radiological knee injuries. RESULTS: Radiological evidence of KF injury was identified in 30 (18.6%) patients. The diagnosis of KF injury was higher in patients who had MRI scans performed within 90 days of injury as compared with ≥90 days after injury (23.7 vs 6.4%; P = .010). Patients with an MRI diagnosis of KF injury had significantly higher rates of lateral meniscal injury (40% vs 18%; P = .007), posteromedial tibial bone marrow edema (73% vs 44%; P = .003), and injury to the lateral collateral ligament (13% vs 3%; P = .019) or medial collateral ligament (23% vs 8%; P = .019). CONCLUSION: The prevalence of injury to the KF in patients with ACL injury as diagnosed by MRI was relatively low (18.6% of patients). However, the time interval from injury to MRI was relevant to diagnosis, with significantly higher rates of injury identification in patients with early (within 90 days) versus delayed (≥90 days) MRI. KF injury was associated with higher rates of injury to the lateral meniscal and collateral ligaments, as well as posteromedial tibial bone bruising.
Authors: Lachlan M Batty; Andrew Firth; Gilbert Moatshe; Dianne M Bryant; Mark Heard; Robert G McCormack; Alex Rezansoff; Devin C Peterson; Davide Bardana; Peter B MacDonald; Peter C M Verdonk; Tim Spalding; Alan M J Getgood; Kevin Willits; Trevor Birmingham; Chris Hewison; Stacey Wanlin; Andrew Firth; Ryan Pinto; Ashley Martindale; Lindsey O'Neill; Morgan Jennings; Michal Daniluk; Dory Boyer; Mauri Zomar; Karyn Moon; Raely Pritchett; Krystan Payne; Brenda Fan; Bindu Mohan; Gregory M Buchko; Laurie A Hiemstra; Sarah Kerslake; Jeremy Tynedal; Greg Stranges; Sheila Mcrae; LeeAnne Gullett; Holly Brown; Alexandra Legary; Alison Longo; Mat Christian; Celeste Ferguson; Nick Mohtadi; Rhamona Barber; Denise Chan; Caitlin Campbell; Alexandra Garven; Karen Pulsifer; Michelle Mayer; Nicole Simunovic; Andrew Duong; David Robinson; David Levy; Matt Skelly; Ajaykumar Shanmugaraj; Fiona Howells; Murray Tough; Pete Thompson; Andrew Metcalfe; Laura Asplin; Alisen Dube; Louise Clarkson; Jaclyn Brown; Alison Bolsover; Carolyn Bradshaw; Larissa Belgrove; Francis Millan; Sylvia Turner; Sarah Verdugo; Janet Lowe; Debra Dunne; Kerri McGowan; Charlie-Marie Suddens; Geert Declercq; Kristien Vuylsteke; Mieke Van Haver Journal: Orthop J Sports Med Date: 2021-04-06
Authors: Daniel P Berthold; Lukas Willinger; Matthew R LeVasseur; Daniel E Marrero; Ryan Bell; Lukas N Muench; Zenon Kane; Andreas B Imhoff; Elmar Herbst; Mark P Cote; Robert A Arciero; Cory M Edgar Journal: Am J Sports Med Date: 2021-06-04 Impact factor: 6.202