Association of Anterolateral Ligament, Kaplan Fibers, and Condylar Strap Injuries with Posterior Cruciate Ligament, Medial Collateral Ligament, Lateral Collateral Ligament, Meniscal, and Bony Injuries in Patients with High-Grade Anterior Cruciate Ligament Injury: A 3-T Magnetic Resonance Imaging Study

Purpose or Learning Objective: This study investigated the association between injuries of the anterolateral ligament, Kaplan fibers, and condylar strap with concomitant injuries of the posterior cruciate ligament, medial and lateral collateral ligaments, medial and lateral menisci, and osseous structures in patients with high-grade anterior cruciate ligament tears as seen on 3-T magnetic resonance imaging.

Methods or Background: This retrospective cross-sectional study analyzed 120 knee magnetic resonance imaging examinations of patients with high-grade anterior cruciate ligament tears. Two musculoskeletal radiologists independently evaluated the presence and severity of injuries to these anterolateral structures and their correlation with associated injuries to the posterior cruciate ligament, medial collateral ligament, lateral collateral ligament, medial and lateral menisci, and osseous structures (fractures and marrow contusions). Severity of injuries were categorized into grade I, grade II, and grade III sprains. Associations between injuries to these structures were analyzed using the chi-square test.

Results or Findings: Among 120 patients with high-grade anterior cruciate ligament injuries, anterolateral ligament injuries were present in 51.7% (36.7% grade II, 15.0% grade III), condylar strap injuries in 52.5% (36.7% grade II, 15.8% grade III), and Kaplan fibers injuries in 25.8% (20.0% grade II, 5.8% grade III). Posterior cruciate ligament injuries were detected in 25.0%, medial collateral ligament injuries in 31.7%, and lateral collateral ligament injuries in 13.3% of patients. Medial menisci tears occurred in 52.5%, lateral menisci tears in 23.3%, and bony injuries in 77.5% of cases. Anterolateral ligament, Kaplan fibers, and condylar strap injuries showed significant correlation with medial collateral ligament tears (P = 0.001, P = 0.001, P < 0.001, respectively) and lateral collateral ligament tears (P < 0.001 for all three structures). Additionally, anterolateral ligament, Kaplan fibers, and condylar strap injuries showed significant correlation with bony injuries (P < 0.001, P = 0.011, P < 0.001, respectively). Only condylar strap injuries were significantly associated with posterior cruciate ligament injuries (P = 0.018). No statistically significant associations were found with meniscal tears.

Conclusion: This radiologic investigation confirms significant associations between injuries of the anterolateral complex structures (anterolateral ligament, Kaplan fibers, and condylar strap) and concomitant medial collateral ligament, lateral collateral ligament, posterior cruciate ligament, and osseous injuries in patients with high-grade anterior cruciate ligament tears. These findings suggest a potential biomechanical relationship that could play a role in diagnosing and treating anterolateral knee stability in patients with high-grade anterior cruciate ligament injuries.

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Artikel online veröffentlicht:
02. Juni 2025