ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026
Lateral meniscus injuries have more impact on pivot shift than anterolateral complex injuries in anterior cruciate ligament-injured knees.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk factors for high-grade pivot shift in patients with anterior cruciate ligament tears combined with lateral meniscus posterior root tears: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Development of machine learning models for preoperative prediction of insufficient clinical improvement after anterior cruciate ligament reconstruction.BMC musculoskeletal disorders · 2026Article
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this prospective study was to investigate the effect of Kaplan fibres (KF), anterolateral ligament (ALL) and lateral meniscus (LM) injuries on preoperative anterolateral rotational instability (ALRI) in anterior cruciate ligament (ACL)-injured knees. It was hypothesised that injuries to the ALC (i.e., KF and ALL) and to the LM would increase the preoperative anterolateral rotatory knee instability (ALRI) quantified by the pivot shift (PS) test.
methodsA prospective registry study was conducted and patients who underwent primary unilateral ACL reconstruction were included. The PS test was preoperatively performed and quantified using the PIVOT iPad application. The anterior translation of the lateral tibia plateau (ATLT) was measured and the side-to-side difference (SSD) was calculated. The PS test was additionally graded according to IKDC criteria. Injuries to the KF, ALL and LM were diagnosed on acute preoperative magnetic resonance imaging (MRI) scans. Student's t-test was used to compare means and binary regression analysis was used to calculate odds ratio (OR). Statistical significance was set to p < 0.05.
resultsOne hundred and twenty-four patients with a mean age of 29.9 ± 11.2 years were included in this study (61% male, 61% right knees). Patients with a LM injury showed a higher likelihood of having a high-grade PS (odds ratio [OR] = 2.5, p = 0.045). Complete radial meniscus tears of the LM significantly increased the ATLT in the quantified PS test compared to patients with an intact meniscus (p < 0.05). Injuries to the ALL, to the KF or a combination of both were not associated with high-grade PS or an increased ATLT.
conclusionConcomitant LM tears were associated with a clinical high-grade PS. Complete radial meniscus tears of the lateral meniscus significantly increased the ATLT compared to intact meniscus. Injuries to the ALL or to the KF were not associated with high-grade PS or an increased ATLT. This study provides new clinical evidence that concomitant LM injuries contributes to increased ALRI, highlighting the importance of addressing these structures during ACL reconstruction to optimise rotational instability. LEVEL OF EVIDENCE: Level III diagnostic studies.
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