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Year : 2021  |  Volume : 5  |  Issue : 1  |  Page : 24-29

Rotational instability of the knee: Injury of anterior cruciate and anterolateral knee ligaments, MRI findings

1 Department of Orthopaedic Surgery, Hospital Español de México; Department of Orthopaedic Surgery, Centro Médico ABC Santa Fe, Mexico City, Mexico
2 Department of Orthopaedic Surgery, Hospital Español de México, Mexico City, Mexico

Correspondence Address:
Dr. Ramón Gonzalez-Pola
Hospital Español de Mexico, Av. Ejército Nacional 613, Col. Granada, Del. Miguel Hidalgo, 11520 CDMX
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmsr.jmsr_68_20

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Objectives: The anterior cruciate ligament (ACL) is a major stabilizing structure of the knee, restraining force of anterior translation, while also preventing excessive tibial medial and lateral rotation. Persistent rotatory knee laxity is increasingly recognized as a common finding after ACL reconstruction. The impact of the anterolateral knee structures is now known to be significant. This study aimed at evaluating patients with the symptoms of knee rotational instability through the use of simple magnetic resonance imaging (MRI) looking for the presence and combined injury of the ACL and anterolateral ligament (ALL). Methods: Descriptive study of 564 MRIs of patients with lesions of the ACL and symptoms of rotational instability, which were retrospectively evaluated in 5 years. The authors assessed the images. The visibility of ALL in T1, T2, and FatSat was evaluated in coronal, axial, and sagittal sections, as well as the presence of lesions. Results: The ALL was visible in a total of 505 MRIs (89.5%) similar to those previously reported in the literature, and its lesion was accompanied in 121 patients with partial ACL injury (23.9%), in 141 with total rupture of ACL (27.8%). Conclusions: The ALL is a dense structure seen by MRI in the coronal plane, similar to that of any other ligament structure, and its lesion was found, in conjunction with an ACL lesion, in 46.4% of the patients with the clinical symptoms of rotational instability, and it can also present itself as an isolated injury.

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