iatrogenic meniscus posterior root injury following reconstruction of the posterior cruciate...

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Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen, and Robert F. LaPrade JBJS Case Connect Volume 4(1):e20 February 26, 2014 ©2014 by The Journal of Bone and Joint Surgery, Inc.

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Page 1: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament

by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen, and Robert F. LaPrade

JBJS Case ConnectVolume 4(1):e20

February 26, 2014

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

T2-weighted coronal MRI of the right knee shows an intact posterior root of the medial meniscus prior to the initial PCL reconstruction.

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

An intraoperative arthroscopic image of the repair of the posterior horn of the medial meniscus (arrow) just lateral to its attachment site.

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

T1-weighted coronal MRI of the right knee taken at the index injury demonstrates an intact posterior horn of the medial meniscus.

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

MRI two years following conservative management demonstrates an intact posterior root attachment of the medial meniscus.

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

T1-weighted coronal MRI of the right knee following PCL reconstruction demonstrates a detachment of the posterior root of the medial meniscus.

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

Coronal CT scan demonstrating the tibial tunnel coursing into the anatomic location of the posterior root attachment of the medial meniscus.

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

Sagittal CT scan demonstrating the PCL tibial reconstruction tunnel passing into the root attachment of the posterior horn of the medial meniscus.

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

T2-weighted coronal MRI of the left knee detachment of the posterior horn of the lateral meniscus.

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 10: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

Coronal CT image of the left knee demonstrating a lateral tunnel placement of the tibial tunnel through the anatomical site of the posterior horn of the lateral meniscus.

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 11: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 12: Iatrogenic Meniscus Posterior Root Injury Following Reconstruction of the Posterior Cruciate Ligament by Nicholas I. Kennedy, Max P. Michalski, Lars Engebretsen,

Nicholas I. Kennedy et al. JBJS Case Connect 2014;4:e20

©2014 by The Journal of Bone and Joint Surgery, Inc.