Abstract
OBJECTIVE: To investigate the clinical correlation between internal knee rotation and the association of injuries between anterolateral (ALL) and anterior cruciate (ACL) ligament. METHODS: Thirty-eight knees of 19 fresh corpses (all males, mean age: 28-years-old) were evaluated by simulating physical examination through manual rotational tests at 90 degrees of flexion. Kirschner wires were placed in parallel in the femur and tibia, and measurements were obtained using a goniometer. The obtained data were compared against the intact ACL, then to progressive sections of the ACL, iliotibial tract, and anterolateral ligament. RESULTS: Isolated release of the ACL induced an increase (+55.6%, p < 0.001) in internal rotation at 90 degrees of flexion, when compared to the internal rotation of the intact knee. After ACL release, associated release of the iliotibial tract (ITT) induced an increase (+31.6%, p < 0.001) in the internal rotation of the knee at 90 degrees of flexion, and a marked increase (+104%, p < 0.001) when compared to the ACL-intact knee. After ACL and ITT release, an additional ALL release induced a significant increase (+27.8%, p < 0.001) in the internal rotation of the knee at 90 degrees of flexion, and in comparison with the intact ACL knee (+162%, p < 0.001). CONCLUSION: There is an increase in internal rotation of the knee in the ACL injury. The association with ALL injury leads to a pronounced increase of internal rotation when compared to the uninjured knee. Therefore, the presence of pronounced internal knee rotation is a clinical sign of associated injury to these structures.