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✅ Knee MRI Mastery/Chap 2.ACL and PCL

(Fig 2-E.16) Bone Contusions In PCL Hyperextension Injury

by MSK MRI 2024. 3. 16.

https://youtu.be/EPclnY3G4AY

https://youtu.be/UgiSgNcqguA

📌 PCL Hyperextension Injury📌

 

1️⃣Hyperextension Injuries: 

  • These injuries can lead to contusions of the anterotibial articular surface and the anterior aspect of the femoral condyle. 
  • Severe hyperextension injuries may also be associated with a tear of the ACL, PCL, posterior capsule, and injuries to the posterolateral or posteromedial corners.
  • Reference: Magn Reson Imaging Clin N Am 22 (2014) 557–580. Stoller's Orthopaedics and Sports Medicine: The Knee.

 

2️⃣ External Tibial Rotation and Valgus Moment: 

  • External tibial rotation causes the force vector to produce a valgus moment. 
  • This action relatively shortens and unloads the posterolateral corner structures, causing the force vector to be absorbed mostly by the lengthened posteromedial corner structures, which are under higher relative tension. 
  • The contusion pattern follows the net vector, involving the anterolateral tibia and femur.
  • Reference: Magn Reson Imaging Clin N Am. 2014 Nov;22(4):621-48.

 

3️⃣ Internal Tibial Rotation and Varus Moment: 

  • Hyperextension during internal tibial rotation generates a varus moment. 
  • This shortens and unloads the posteromedial structures and lengthens the posterolateral corner structures, which absorb most of the injury burden. 
  • The contusion pattern again follows the net vector, usually involving the anteromedial tibia and femur.
  • Reference: Magn Reson Imaging Clin N Am. 2014 Nov;22(4):621-48.

 

♦️ Rupture of the Meniscotibial Ligament: 

  • A rupture of the meniscotibial ligament can lead to instability of the meniscus, as this ligament normally keeps the meniscus tightly adhered to the tibia and likely prevents its extrusion. 
  • When ruptured, the meniscotibial component is associated with pathological mobility of the medial meniscus.
  • Reference: Semin Musculoskelet Radiol. 2016 Feb;20(1):12-25. Stoller's Orthopaedics and Sports Medicine: The Knee.

 

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