✅ Chronic ACL tears
- Laxity and abnormal horizontal orientation of fibers are the most useful features for detecting ACL disruption in the chronic setting as opposed to fiber discontinuity and bone contusions, which are the most useful features in the acute setting.
- Chronically torn ACL is often seen with the horizontal axis or may display more vertical orientation and discontinuity/retraction of proximal attachment.
- Absence of ACL tissue in the lateral intercondylar notch, indicating empty notch sian on coronal MR images (empty lateral wall)
- The ACL begins to heal by forming variable scar tissue following the acute injury, and the increased T2 signal will gradually resolve.
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