Publication:

Patterns of meniscal tears in patients with anterior cruciate ligament injury

Background Anterior cruciate ligament (ACL) injuries are among the most common intra-articular knee injuries and are frequently associated with meniscal tears. The menisci play a crucial role in load transmission, stability, and joint congruency, and their injury in ACL-deficient knees accelerates degenerative changes and worsens functional outcomes. Understanding the pattern and distribution of meniscal tears in ACL injuries is essential for early diagnosis, appropriate surgical planning, and prevention of long-term osteoarthritis. Objectives were to evaluate the pattern of meniscal tears in patients with ACL injury.

Methods This observational study was conducted in the Department of Orthopaedics, Government Medical College, Kottayam, over a period of 1.5 years from June 2024 to December 2025. A total of 272 patients aged ≥18 years with clinically and radiologically confirmed ACL injury were included. Patients with associated posterior cruciate ligament (PCL), medial collateral ligament (MCL), or lateral collateral ligament (LCL) injuries without ACL involvement, previous knee surgeries, or advanced osteoarthritis (Kellgren-Lawrence grade >3) were excluded. All patients underwent detailed clinical evaluation, magnetic resonance imaging (MRI) of the knee, and diagnostic arthroscopy where indicated. Data regarding the presence, type, and anatomical location of meniscal tears were recorded and analysed using SPSS version 26.

Results Meniscal injury was present in 202 patients (74.3%). Isolated medial meniscus tears were the most common (58.4%), followed by combined medial and lateral meniscus tears (26.7%), while isolated lateral meniscus tears were least frequent (14.9%). The posterior horn of the medial meniscus was the most commonly involved site (65.3%), followed by the posterior horn of the lateral meniscus (24.3%). The body of the lateral meniscus was the least affected region (6.9%).

Conclusions The study demonstrates a high prevalence of meniscal tears in ACL-injured knees, with predominant involvement of the medial meniscus, especially its posterior horn. Early detection and timely management of ACL injuries are essential to prevent secondary meniscal damage and long-term degenerative changes of the knee joint.