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Relationship between three-dimensional MRI findings of the anterolateral ligament of the knee and rotational instability
Author(s):
Muramatsu K. (Japan)
,
Muramatsu K. (Japan)
Affiliations:
Sasaki Kana
,
Sasaki Kana
Affiliations:
Hachiya Y.
Hachiya Y.
Affiliations:
ESSKA Academy. Muramatsu K. 05/09/18; 209421; P05-500 Topic: Sports Related Injuries
Dr. Koichi Muramatsu
Dr. Koichi Muramatsu
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Abstract
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Objectives: To investigate the relationship between three-dimensional magnetic resonance imaging (3D-MRI) findings of the anterolateral ligament (ALL) in anterior cruciate ligament (ACL) deficient knees and rotational instability.

Methods: 100 ACL deficient knees underwent 3D-MRI (PWD-SPACE) using a 3.0T scanner. The section passing through the center of the lateral epicondyle of the femur and the midpoint on a line joining the posterior margin of Gerdy's tubercle on the lateral condyle of the tibia with the anterior margin of the head of the fibula was used as the reference section, and coronal cross-sectional images were reconstructed for a total of 50-60 slices with a slice thickness of 0.5 mm in front of and behind this plane. The ALL was defined for the purpose of this study as the low signal band originating proximal and posterior to the lateral epicondyle of the femur, crossing the proximal surface of the LCL, and reaching the middle third of the lateral condyle of the tibia. Evaluation of the ALL was performed using the following classification; Type A: ligament visualized as continuous, clearly defined low-signal band, Type B: warping, thinning, or iso-signal changes, Type C: ligament without clear continuity.
The pivot shift test was performed under general anesthesia, and the grade was compared with MRI classification.

Results: 3D-MRI classification of the ALL: 27 Type A (27%), 65 Type B (65%), and 8 Type C (8%). Pivot shift grade: 42 Grade 1 (42%), 41 Grade 2 (41%), 17 Grade 3 (17%).
The rate of grade 2 and 3 pivot shift was 59.3% (16/27) in Type A and 57.5% (42/73) in Type BC. There was no significant difference.

Conclusions: 3D-MRI allowed clear visualisation and evaluation of the ALL in ACL deficient knees. However, 3D-MRI findings of the ALL were not associated with tibial rotational instability.

Keywords:
anterolateral ligament, anterior cruciate ligament, MRI
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