[doctorF]

guys i have a query....

About "unhappy triad"

Goljan's RR says:

It consists of damage to medial leminiscus, anterior cruciate and medial meniscus (pg536)

Whereas FA says::

It's a common football injury consists of damage to medial leminiscus, anterior cruciate and lateral (not medial) meniscus (pg 366)

 

[lee-usmle]

It's the lateral meniscus

Initially it was thought to be the medial meniscus. But in 1991 the triad has been redefined to the Lateral Meniscus

Ref:
http://ajs.sagepub.com/content/19/5/474

 

[drnyinyithan]

reply to un happy triad conflict

UNhappy triad injury to the knee happens in soccer game, when the person got kicked from the lateral side of the knee...this will cause opening or stretching of the structures on the medial side of the knee...namely Medial longitudinal ligament, medial meniscus and anterior cruciate ligament....and these 3 structures are damaged and hence called TRIAD........THAT was the original theory....BUT later in 1990's, they did the research and studies of sports knee injury, which showed, LATERAL meniscus was also injured in those injury....and was stated as 56% for lateral meniscus and 44% for medial meniscus......I hope this answer your question..

 

[plasticsurgeon]

Its medial???

Initially it was thought to be the medial meniscus. But in 1991 the triad has been redefined to the Lateral Meniscus

Ref:
http://ajs.sagepub.com/content/19/5/474

Well, I have checked Campbell orthopedics which considered to be the Bible of orthopedics. Even it says Medial Meniscus

 

[dr.Irina]

The "classic unhappy triad" (O’Donoghue’s triad) due to an acute valgus stress on the knee involves the ACL, MCL, and medial meniscus.
However, recent studies suggest two things:
1. The triad of ACL, MCL and lateral meniscus injury is actually more common than the classic triad following acute valgus stress on the knee
2. In patients that do develop the classic unhappy triad , only the ACL and MCL are acutely injured during the acute valgus stress on the knee, while the injury to the medial meniscus is the result of chronic injury secondary to ACL insufficiency

 

[whocares13]

Unhappy Triad

Getting confused.

Unhappy Triad is:
1) injury to ACL
2) injury to MCL
3) injury to Medial meniscus or Lateral meniscus??

Kaplan says Medial and FA says Lateral(not medial) on page 366.

Can anyone explain??

Thank you.

EDIT: I read this thread and I think FA is correct and it is Lateral Meniscus and not Medial Meniscus.

Also confirmed from wikipedia.

Ref: Unhappy Triad

Ref: Wikipedia

 

[docji]

Medial Meniscus

First Aid some errors now and then. Its medial Meniscus!

Getting confused.

Unhappy Triad is:
1) injury to ACL
2) injury to MCL
3) injury to Medial meniscus or Lateral meniscus??

Kaplan says Medial and FA says Lateral(not medial) on page 366.

Can anyone explain??

Thank you.

 

[patient doctor]

It's medial meniscus
Campbell's Operative Orthopaedics, 11th ed.
Chapter 43 – Knee Injuries

 

[whocares13]

I read this thread and I think FA is correct and it is Lateral Meniscus and not Medial Meniscus.

Also confirmed from wikipedia.

Ref: Unhappy Triad

Ref: Wikipedia

 

[drnirajmavani]

Unhappy triad occurs when u get a blow on ur knee frm the lateral side....so its the the LATERAL meniscus thats going to crush between the femur and tibia...

 

[Hope2Pass]

Read these answers by some members on a different post -->

Initially it was thought to be the medial meniscus. But in 1991 the triad has been redefined to the Lateral Meniscus

Ref:
http://ajs.sagepub.com/content/19/5/474

UNhappy triad injury to the knee happens in soccer game, when the person got kicked from the lateral side of the knee...this will cause opening or stretching of the structures on the medial side of the knee...namely Medial longitudinal ligament, medial meniscus and anterior cruciate ligament....and these 3 structures are damaged and hence called TRIAD........THAT was the original theory....BUT later in 1990's, they did the research and studies of sports knee injury, which showed, LATERAL meniscus was also injured in those injury....and was stated as 56% for lateral meniscus and 44% for medial meniscus......I hope this answer your question..

Look here, they have a good discussion - http://www.usmle-forums.com/usmle-step-1-forum/2405-unhappy-triad-lateral-medial-mensicus-injury.html

 

[menatallah Elgohary]

confused

i searced for it and yes it's right that recently they found injury to lateral menscus more common but in many books like kaplan and others still sticking to the medial menscus so if it comes in exam which one should be chossen ??????? :scared:

 

[whocares13]

i searced for it and yes it's right that recently they found injury to lateral menscus more common but in many books like kaplan and others still sticking to the medial menscus so if it comes in exam which one should be chossen ??????? :scared:

Lateral meniscus as FA have written with bold letters NOT MEDIAL

 

[dr pinky]

If injury is acute then it's Lateral meniscus
If injury is Chronic then it's Medial meniscus

 

[USMLE-Syndrome]

unhappy triad knee injury (1st aid& kaplan )

unhappy triad knee injury in 1st aid page 366
(ACL & lateral meniscus and MCL)
while in kaplan anatomy page 300 is (ACL & MCL& medial menscus )

which one is right

???????????????????????????

 

[dr.muhamad]

unhappy triad knee injury in 1st aid page 366
(ACL & lateral meniscus and MCL)
while in kaplan anatomy page 300 is (ACL & MCL& medial menscus )

which one is right

???????????????????????????

okay let me tell u sth i searched about this thing alot
and finally i came up with this; they r both right and it is like 60% lateral meniscus and 40 % medial
so the best to answer is lateral but if u find one answer saying medial then choose it

 

[shyangel18]

according to UWORLD.. its Medial meniscus medial collateral lig and ant cruciate ligament!
so if i were to chose bw the two.. medial or lateral meniscus.. id go with UW!!
note i jus did that question a couple of days ago! so m 100% sure!!

 

[rapiddo]

Unhappy Knee Triad

I'm seeing conflicting ideas about the unhappy knee triad :
Kaplan Lecture notes says: Medial Meniscus, Medial Collateral Ligament and Anterior Cruciate Ligament while
First Aid 2011 says: Lateral Meniscus, Medial Collateral Ligament and Anterior Cruciate Ligament.
Please, need clarification.
Thanks.

 

[Faith32]

I'm seeing conflicting ideas about the unhappy knee triad :
Kaplan Lecture notes says: Medial Meniscus, Medial Collateral Ligament and Anterior Cruciate Ligament while
First Aid 2011 says: Lateral Meniscus, Medial Collateral Ligament and Anterior Cruciate Ligament.
Please, need clarification.
Thanks.

From doing questions the correct answer is LM,MCL and ACL. I guess the lateral meniscus is the most common. I found this article, hopefully it will help.
http://ajs.sagepub.com/content/19/5/474

 

[ALittleTeaPot]

I do not know the story behind how O'Donoghue originally described this now classic "Unhappy Triad". But let us remember that even half a century ago doctors (and other people) often relied on pure academic reasoning without proof from clinical studies for medical decision making (think why we didn't use beta blockers in CHF). I am not saying this is what O'Donoghue did but let us think of the philosophy behind this unhappy triad.

1. Knee injuries are common.

2. Common sporting knee injuries involve a lateral stress applied to the knee (e.g. a side tackle). This usually involves an anterior component as well as the tackler comes from behind.

3. For common things we like to have triads! (or mnemonics, or just any easy stereotype to remember things by).

4. The ACL is weak so it is torn easily. The lateral application of force exerts stress on the Medial Collateral Ligament which is actually connected to the medial meniscus. It "makes sense" that torn of both should occur together. Eureka!

I. ACL tear
II. Medial collateral ligament tear
III. Medial meniscus tear

5. Evidence-based medicine comes along and attempts to test this about a decade later. Unfortunately the triad really does not hold. Lateral meniscus tear are far more common so a re-formulation of this concept should take place. So now the triad should really be

I. ACL tear
II. MCL tear
III. Lateral meniscus tear

But really it is a variable concept. Some textbooks will tell you the classic triad, some textbooks won't tell you such a triad at all. In fact other than FA, I've never seen this triad described with a lateral meniscus tear. I presume that it means it can't be tested unless physical findings are given but I am probably wrong.