The unhappy triad

[Gabby]

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I learned the unhappy triad referred to MCL, ACL, and medial meniscus. USMLERx says it's ACL, MCL, and lateral meiscus. Is this an error or were my professors wrong?

 

[iA-MD2013]

Wiki: "Meta-analysis shows that in acute injuries of the ACL associated with a meniscus tear 44% were of the medial meniscus whereas 56% were of the lateral meniscus; in chronic ACL insufficiency 70% were medial whereas 30% were lateral."

http://en.wikipedia.org/wiki/Unhappy_triad

 

[mednsports]

Yeah that's pretty confusing. The "classic" terrible triad/unhappy triad consisted of the acl/mcl/medial meniscus. A meta-anaylsis was published challenging (somewhat) that classic definition. Pretty much, in layman's terms, if you're fat/old/ex-athlete/half decent athlete/have chronic damage to you're ACL, you are more likely to tear your medial meniscus with the happy triad. If you're an elite athlete and you "blow your knee out", you're more likely to tear your lateral meniscus. This is coming straight from Dr. Andrews' mouth...and he pretty much is sports med

 

[Gabby]

Thanks guys! I'll just go with athlete = lateral.

 

[unsung]

Thanks guys! I'll just go with athlete = lateral.

The way I learned it, the key is whether or not it's an acute injury. Acute more likely to be lateral.

 

[Shadowmoses]

While we are on the topic of knee ligament injuries, can anyone explain why in an isolated lateral collateral ligament injury the leg has to be medially rotated when there is an abnormal varus stress on the knee? I know when the knee is fully extended the LCL travels downwards and posteriorly when it goes from the condyle of the femur to the neck of the fibula. Is the ligament more exposed when you internally rotate your knee?😕

 

[ar2388]

i would imagine that it is stretched more when your knee is medially rotated... but this is based on just medially rotating my own knee and thinking about the lateral aspect lol