From Andrei:Great observations and thoughts
Hey Phil,
I think I remember you teaching me/us that mucoid deg. of the ACL is a sign of chronic overload.
I for myself noticed over the years a (subjectively, at least) higher incidence of ACL injuries in people with patellofemoral malalignment (many with a patella alta).
Mind you, I never did a statistical evaluation, this is just my impression after reading way over 20,000 knee MRIs over the years.For a while I thought I’d publish that and searched for literature about it, but only found something in a physical therapy journal (so far).
Also, when it comes to meniscal lesions, the lateral meniscus seems to get injured more frequently in these patients as opposed to the medial meniscus in the general population.
The scans you sent seem to show signs of patellofemoral malalignement, including superolateral Hoffa’s edema and a relatively high Caton-Deschamps-Index as defined for MRI.
In my view, there might be an association here between ACL degeneration, lat. meniscus lesion and the surmised patellofemoral malalignement. My impression is that this holds for chronic lesions as well as (the likelyhood of) acute tears.
I’d be interested if you or other OCADers have made similar observations.
Have a lovely weekend,
Andrei
Somewhat unusual longitudinal tear of the anterior horn of the lateral meniscus associated with a high grade partial ACL. 38 y/oF who slipped and fell.
I’ve seen many cases of mucoid degeneration of the ACL where the mucoid material extends into the ant horn of the lateral meniscus through the shared root attachment. (a few times arthroscopically proven)
I have never seen an ACL tear with this association (don’t remember is more like it) and think it must be a twisting shear type injury? Is mucoid degeneration sometimes a chronic partial tear? I’m sure folks here know. Most of the literature concentrates on the posterior horn injuries with an ACL tear.
If interesting to you, feel free to reply and discuss. I can certainly learn.
Phillip
