A 23-year-old man is admitted to the emergency department after injuring his knee while playing football. During physical examination there is pain and swelling of the knee, in addition to locking of the knee. Radiographic examination reveals a bucket-handle meniscal tear. Which of the following ligaments is most likely injured?
(d) Source: GAS 559, 576-577, 583, 646-647; GA 303-305 Both the medial and lateral menisci are subject to rotational injuries and may be torn. The medial meniscus is much more liable to injury because it is attached to the fused deep layer of the medial collateral ligament and joint capsule. The lateral meniscus is separated from the fibular collateral ligament and is external to the capsule of the knee joint. Commonly seen in football players' knees, meniscal tears are usually diagnosed by MRI or by arthroscopy. The presenting symptoms of tearing may be pain and swelling, or locking of the knee. Locking of the knee suggests a bucket-handle tear, in which a partly detached cartilage wedges between the tibia and femur, inhibiting further movement. A bucket-handle tear is often associated with rupture of the anterior cruciate ligament. Sometimes a momentary click can be heard in flexion/extension movements of the knee. Meniscectomy is a successful operation, but currently there is greater emphasis on repairing small tears. Meniscal cysts can form secondary to meniscal tears and some of these can also be treated arthroscopically.
Posterior cruciate
Medial collateral
Lateral collateral
Anterior cruciate
Lower Extremity