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Longitudinal Vertical Tear with High Grade ACL tear

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Next case is a 23-year-old, uh, woman

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with knee injury playing ultimate Frisbee.

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And this is case four. We see a longitudinal vertical tear

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here at the posterior horn of the medial meniscus,

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and it extends towards the body,

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but it it involves this periphery.

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The peripheral third, the ACL,

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uh, also appears abnormal here.

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Uh, most of the abnormalities in the anterior medial, um,

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bundle, but you can see that these margins aren't,

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aren't too far apart.

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They're not splayed apart,

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and they, uh, an ACL plane was, uh, done.

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And there's just, this is a high grade ACL tear,

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but some of these poster lateral, um, fibers are,

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uh, still intact.

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Um, but, but definitely this is a, a high grade tear.

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So, uh, on clinical exam, uh,

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the patient had a one plus lockman that was a soft endpoint.

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Everybody agreed that, um, uh, uh, preoperatively

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that this was gonna be a high grade tear.

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But arthroscopic, um, uh,

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arthroscopy was done six weeks after the injury.

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And surprisingly, the ACL, uh, didn't look that bad.

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Uh, and it felt, uh, okay, when they probed the, uh,

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near the femoral, uh,

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or proximal attachment, you can be basically see that, uh,

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it did look irregular.

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And so what they did, uh, was they microfractured it, um,

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they basically poked a lot of holes in it, um, to try

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to incite a healing response because of, uh, her age.

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She was, uh, 23 years old.

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And, uh, one

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and a half years later, um, she had a knee, another knee,

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MRI, and, uh, it healed pretty well.

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So, uh, microfactors can work in some

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of these partial ACL tears, don't necessarily, uh,

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need reconstruction.

Report

Faculty

Donald Resnick, MD

Professor Emeritus, Department of Radiology

University of California, San Diego

Mini N. Pathria, MD, FRCP(C)

Division Chief, Musculoskeletal Imaging

University of California San Diego

Eric Y. Chang, MD

Adjunct Professor, Radiology

University of California, San Diego

Brady K. Huang, MD

Clinical Professor of Radiology

UC San Diego Medical Center

Tags

Musculoskeletal (MSK)

MRI

Knee