MRI-Based Assessment of the Common Peroneal Nerve in ACL-Injured Versus Normal Knees: Implications for Inside-Out Lateral Meniscus Repair

Articles in Press

Document Type : RESEARCH PAPER

Authors

1 Government Siddhartha medical college, Dr NTR health university, vijayawada, andhra pradesh, india

2 government siddhartha medical college, Dr NTR health university, vijayawada

3 “Sri Dhaatri”, 23, Lane 2,SKDGOC, Vijayawada Andhra Pradesh, India

4 Government siddhartha medical college, Dr NTR health university, vijayawada

10.22038/abjs.2025.84236.3831

Abstract

Objective: This study investigates the risk of CPN injury by measuring the nerve's proximity

to the trajectory of a straight needle inserted from the anteromedial portal at the knee joint

level during inside-out lateral meniscus repairs in both ACL-injured and normal knees.

Methods: In this retrospective study, we examined MRI scans of 30 ACL-injured knees and

30 normal knees. A reference line was drawn 1 cm medial to the patellar tendon at the joint

level, extending to the lateral margin of the popliteus and continuing posteriorly.

Perpendicular distances from this line to the CPN were measured to compare anatomical

variations between the groups. These measurements were analyzed using paired t-tests, with a

p-value of less than 0.05, which is considered statistically significant.

Results: Analysis of 60 MRI scans revealed that the CPN is located significantly closer to the

reference line in ACL-injured knees (mean distance: 1.59 cm) compared to normal knees

(mean distance: 2.01 cm), with a p-value of less than 0.005. This finding suggests a higher

potential risk of nerve injury in ACL-injured knees during inside-out meniscal repair

procedures.

Conclusion: The CPN is located significantly closer to potential surgical paths in ACL

injured knees compared to normal knees. These findings highlight the importance of

meticulous surgical planning and technique adjustments to minimize the risk of CPN injury

during inside-out meniscus repairs especially when using straight needles.

Keywords: MRI, ACL injured knees, normal knees, lateral meniscus injury, inside-out

technique, straight needle, common peroneal nerve injury.

Level of evidence: Level 3 retrospective comparative study

Keywords

Main Subjects

The Archives of Bone and Joint Surgery

Articles in Press, Accepted Manuscript
Available Online from 25 June 2025

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History

  • Receive Date: 25 November 2024
  • Revise Date: 07 April 2025
  • Accept Date: 13 April 2025

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