Anterior cruciate ligament and bucket handle meniscal tears

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Sports injury 3 months ago

Patient Data

Age: 25 years
Gender: Male

Large joint effusion. Bucket handle tear of the medial meniscus with the fragment flipped into the intercondylar notch. Lateral meniscus is intact.

Full thickness rupture of the anterior cruciate ligament. Posterior cruciate ligament is intact. There is anterior tibial translation of 10 mm.

Lateral collateral ligament is intact. Medial collateral ligament is intact. There is a tiny popliteus tendon sheath effusion. Posterolateral corner structures appear uninjured. There is minor hyperintensity of the posterior knee joint capsule.

Quadriceps and patellar tendons are intact.

No focus of marrow edema or osteochondral fracture is identified. No aggressive focal osseous lesion.​

Case Discussion

Full thickness anterior cruciate ligament tear with a bucket handle tear of the medial meniscus - these injuries often co-occur. The lack of "pivot shift" pattern of bone marrow edema is likely due to the delayed presentation. 

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