Hoveidaei AH, Sattarpour R, Dadgostar H, Razi S, Razi M. Unhappy triad of the knee: What are the current concepts and opinions? World J Orthop 2023; 14(5): 268-274 [PMID: 37304199 DOI: 10.5312/wjo.v14.i5.268]
Corresponding Author of This Article
Mohammad Razi, MD, President, Professor, Surgeon, Department of Orthopedic Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, 8th Ahmad Qasirah Street, Argentina Square, Tehran 1445613131, Iran. mrazi@razimd.info
Research Domain of This Article
Orthopedics
Article-Type of This Article
Evidence Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. May 18, 2023; 14(5): 268-274 Published online May 18, 2023. doi: 10.5312/wjo.v14.i5.268
Unhappy triad of the knee: What are the current concepts and opinions?
Amir Human Hoveidaei, Reza Sattarpour, Haleh Dadgostar, Saeed Razi, Mohammad Razi
Amir Human Hoveidaei, Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran 14395-578, Iran
Reza Sattarpour, School of Medicine, Tehran University of Medical Sciences, Tehran 1416634793, Iran
Haleh Dadgostar, Department of Sports and Exercise Medicine, School of Medicine, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran 1445613131, Iran
Saeed Razi, Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran 1545913487, Iran
Mohammad Razi, Department of Orthopedic Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran 1445613131, Iran
Author contributions: Hoveidaei AH and Sattarpour R contributed equally to the work. All authors contributed to the conception and design of the study; Hoveidaei AH, Sattarpour R, and Razi S drafted the article; Dadgostar H and Razi M made critical revisions related to the important intellectual content of the manuscript; all authors approved the final version of the article to be published.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest with this work.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammad Razi, MD, President, Professor, Surgeon, Department of Orthopedic Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, 8th Ahmad Qasirah Street, Argentina Square, Tehran 1445613131, Iran. mrazi@razimd.info
Received: December 26, 2022 Peer-review started: December 26, 2022 First decision: January 20, 2023 Revised: January 24, 2023 Accepted: April 6, 2023 Article in press: April 6, 2023 Published online: May 18, 2023 Processing time: 142 Days and 20.8 Hours
Abstract
The association between injuries to the anterior cruciate ligament, medial collateral ligament, and medial meniscus (MM) has been known to orthopedic surgeons since 1936; O'Donoghue first used the term "unhappy triad" of the knee to describe this condition in 1950. Later studies revealed that involvement of the lateral meniscus is more common than MM in these cases, leading to a change in the definition. Recent studies have revealed that this triad may be primarily linked to knee anterolateral complex injuries. Although there is not a definite management protocol for this triad, we try to mention the most recent concepts about it in addition to expert opinions.
Core Tip: Traditionally, the anterior cruciate ligament (ACL), medial collateral ligament (MCL), and medial meniscus (MM) were thought to be the unhappy triad of the knee; however, lateral meniscus injuries are thought to be more common in association with ACL and MCL tears. Clinicians, radiologists, and orthopedic surgeons should be aware of the unhappy triad of the knee, while performing physical examinations, radiologic assessments, or knee arthroscopy. MCL spontaneous healing is possible in some cases with lower grades of tear; however, consideration of patient knee alignment and accuracy in MCL size for non-operative treatment decision-making is critical.
