Injuries of the anterior cruciate and medial collateral ligaments of the knee. A retrospective analysis of clinical records--part I.

The difficulty in diagnosing and subsequently treating lesions of the anterior cruciate ligament (ACL) is demonstrated in a review of 136 cases. Twenty-one patients noted a "pop" at the time of injury and each had a lesion of the ACL. The mechanism of injury may be helpful. The commonly seen valgus external rotation injury was noted in 60% of the cases but internal rotation with hyperextension and/or hyperflexion were also reported. The anterior drawer sign, if present, increases the accuracy to 92.1%. Failure of early cast treatment occurred if the ACL was torn but not in lesions confined to the MCL. Early meniscectomy in the cruciate deficient patient did not alleviate the need for further surgery in this group. At surgery the medial meniscus was torn in 93/124 ligament injuries but in addition 14 tears of the lateral meniscus were found. Wound complications were frequent with infection (4.8%) always being associated with hematoma formation (9.5%).