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Skeletal Radiology

Erschienen in:

08.11.2021 | Scientific Article

Medial collateral ligament injury of the knee: correlations between MRI features and clinical gradings

verfasst von: Christopher Watura, Catrin Morgan, David Flaherty, Charles Gibbons, Paul Sookur

Erschienen in: Skeletal Radiology | Ausgabe 6/2022

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Abstract

Objective

To evaluate the degree of correlation between MRI and clinical gradings of medial collateral ligament (MCL) injuries and assess for associated structures on MRI which may influence the clinical perception of MCL laxity.

Materials and methods

All knee MRIs with acute MCL injuries between 2016 and 2020 at our centre were retrospectively reviewed by two blinded musculoskeletal radiologists. The clinic notes were reviewed for clinical gradings.

Results

One hundred and nineteen MRIs included. Forty-eight percent (57/119) agreement between MRI and clinical gradings (κ = 0.21, standard error (SE) 0.07). MRI grades: I 29% (34/119), II 50% (60/119), III 21% (25/119). Clinical grades: I 67% (80/119), II 26% (31/119), III 7% (8/119). In patients with clinical grade III MCL injury, there was waviness of the superficial MCL on MRI in 100% (8/8), deep meniscofemoral ligament tear in 75% (6/8), anterior cruciate ligament (ACL) partial or complete tear in 75% (6/8) and posteromedial corner (PMC) injury in 100% (8/8); compared with 0% (0/111), 34% (38/111), 44% (49/111) and 41% (46/111) respectively in clinical grade I or II injuries (p < 0.05).

Conclusion

Agreement between MRI and clinical gradings of MCL injuries was only ‘fair’, with MRI almost always overestimating the grade of the injury when there was a mismatch. Waviness of the superficial MCL and injuries to the deep MCL, ACL and PMC correlate with clinical instability.

Andrews K, Lu A, Mckean L, Ebraheim N. Review: Medial collateral ligament injuries. J Orthop. 2017. https://doi.org/10.1016/j.jor.2017.07.017.

Liu F, Yue B, Gadikota HR, et al. Morphology of the medial collateral ligament of the knee. J Orthop Surg Res. 2010. https://doi.org/10.1186/1749-799x-5-69.

LaPrade RF, Engebretsen AH, Ly T V, Johansen S, Wentorf FA, Engebretsen L. The anatomy of the medial part of the knee. J Bone Jt Surg - Ser A. 2007. https://doi.org/10.2106/JBJS.F.01176.

Yao L, Dungan D, Seeger LL. MR imaging of tibial collateral ligament injury: comparison with clinical examination. Skeletal Radiol. 1994. https://doi.org/10.1007/BF00223082.

Major NM, Helms CA, Anderson MW, Kaplan PA, Dussault R. Musculoskeletal MRI. Musculoskelet. MRI. 2019. https://doi.org/10.1016/C2013-0-18906-4.

Schweitzer ME, Tran D, Deely DM, Hume EL. Medial collateral ligament injuries: Evaluation of multiple signs, prevalence and location of associated bone bruises, and assessment with MR imaging. Radiology. 1995. https://doi.org/10.1148/radiology.194.3.7862987.

Encinas-Ullán CA, Rodríguez-Merchán ECEC. Isolated medial collateral ligament tears: an update on management. EFORT Open Rev. 2018. https://doi.org/10.1302/2058-5241.3.170035.

Helms CA. The meniscus: Recent advances in MR imaging of the knee. Am J Roentgenol. 2002. https://doi.org/10.2214/ajr.179.5.1791115.

Chahla J, Dean CS, Moatshe G, et al. Meniscal Ramp Lesions: Anatomy, Incidence, Diagnosis, and Treatment. Orthop J Sport Med. 2016;4(7). https://doi.org/10.1177/2325967116657815.

10.

Sandalcidi D, Dommerholt J. Deep dry needling of the hip, pelvis and thigh muscles. Trigger Point Dry Needling An Evid Clin Approach. 2013. https://doi.org/10.1016/B978-0-7020-4601-8.00010-4.

11.

House CV, Connell DA, Saifuddin A. Posteromedial corner injuries of the knee. Clin Radiol. 2007. https://doi.org/10.1016/j.crad.2006.11.024.

12.

Lundquist RB, Matcuk GR, Schein AJ, et al. Posteromedial corner of the knee: the neglected corner. Radiographics. 2015. https://doi.org/10.1148/rg.2015140166.

13.

Hughston JC. The importance of the posterior oblique ligament in repairs of acute tears of the medial ligaments in knees with and without an associated rupture of the anterior cruciate ligament. Results of long-term follow-up. J Bone Jt Surg - Ser A. 1994. https://doi.org/10.2106/00004623-199409000-00008.

14.

Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics. 1977;33(1). https://doi.org/10.2307/2529310.

15.

Majewski M, Susanne H, Klaus S. Epidemiology of athletic knee injuries: a 10-year study. Knee. 2006. https://doi.org/10.1016/j.knee.2006.01.005.

16.

Paletta GA, Warren RF. Knee injuries and alpine skiing: treatment and rehabilitation. Sport Med Eval Res Exerc Sci Sport Med. 1994. https://doi.org/10.2165/00007256-199417060-00006.

17.

LaPrade RF, Bernhardson AS, Griffith CJ, MacAlena JA, Wijdicks CA. Correlation of valgus stress radiographs with medial knee ligament injuries: an in vitro biomechanical study. Am J Sports Med. 2010. https://doi.org/10.1177/0363546509349347.

18.

Memarzadeh A, Melton JT. Medial collateral ligament of the knee: anatomy, management and surgical techniques for reconstruction. Orthop Trauma. 2019. https://doi.org/10.1016/j.mporth.2019.01.004.

19.

LaPrade RF, Wijdicks CA. The management of injuries to the medial side of the knee. J Orthop Sports Phys Ther. 2012. https://doi.org/10.2519/jospt.2012.3624.

20.

Boutin RD, Fritz RC, Walker REA, Pathria MN, Marder RA, Yao L. Tears in the distal superficial medial collateral ligament: the wave sign and other associated MRI findings. Skeletal Radiol. 2020;49(5). https://doi.org/10.1007/s00256-019-03352-4.

21.

Taketomi S, Uchiyama E, Nakagawa T, et al. Clinical features and injury patterns of medial collateral ligament tibial side avulsions: “Wave sign” on magnetic resonance imaging is essential for diagnosis. Knee. 2014;21(6). https://doi.org/10.1016/j.knee.2014.08.019.

22.

Shelbourne KD, Nitz PA. The O’Donoghue triad revisited. Am J Sports Med. 1991. https://doi.org/10.1177/036354659101900509.

23.

Tandogan NR, Kayaalp A. Surgical treatment of medial knee ligament injuries: Current indications and techniques. EFORT Open Rev. 2016;1(2). https://doi.org/10.1302/2058-5241.1.000007.

24.

Phisitkul P, James SL, Wolf BR, Amendola A. MCL injuries of the knee: current concepts review. Iowa Orthop J. 2006.

25.

DeLong JM, Waterman BR. Surgical Repair of Medial Collateral Ligament and Posteromedial Corner Injuries of the Knee: A Systematic Review. Arthrosc - J Arthrosc Relat Surg. 2015;31(11). https://doi.org/10.1016/j.arthro.2015.05.010.

26.

Rasenberg EIJ, Lemmens JAM, van Kampen A, et al. Grading medial collateral ligament injury: comparison of MR imaging and instrumented valgus-varus laxity test-device. A prospective double-blind patient study. Eur J Radiol. 1995. https://doi.org/10.1016/0720-048X(95)00660-I.

27.

Bergin D, Keogh C, O’Connell M, et al. Atraumatic medial collateral ligament oedema in medial compartment knee osteoarthritis. Skeletal Radiol. 2002. https://doi.org/10.1007/s002560100418.

Titel: Medial collateral ligament injury of the knee: correlations between MRI features and clinical gradings
verfasst von: Christopher Watura
Catrin Morgan
David Flaherty
Charles Gibbons
Paul Sookur
Publikationsdatum: 08.11.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Skeletal Radiology / Ausgabe 6/2022
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-021-03949-8

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Medial collateral ligament injury of the knee: correlations between MRI features and clinical gradings