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Unhappy triad
An unhappy triad (or terrible triad, "horrible triangle", O'Donoghue's triad or a "blown knee") is an injury to the anterior cruciate ligament, medial collateral ligament, and the Medial meniscus. The triad refers to a complete or partial tear of the anterior cruciate ligament, medial collateral ligament, and the medial meniscus. Originally the "unhappy triad" included the medial meniscus and not the lateral meniscus. However, during the 1990s, analysis indicated that the 'classic' O'Donoghue triad is actually an unusual clinical entity among athletes with knee injuries. Some authors mistakenly believe that in this type of injury, acute tears of the medial meniscus always present with a concomitant lateral meniscus injury. This is definitely not true. However, the lateral meniscus tears are more common than medial meniscus tears in conjunction with sprains of the ACL according to the 1990s study.
==History==
In 1936 Cambell stated that an "impairment of the anterior crucial and medial ligaments is associated with injuries of the internal cartilage". In 1950, O'Donoghue described the unhappy triad as: (1) rupture of the medial collateral ligament, (2) damage to the medial meniscus and (3) rupture of the anterior cruciate ligament. O'Donoghue estimated the incidence rate in the traumatic sports knee to be 25%.
In 1991, Shelbourne and Nitz questioned the validity of O'Donoghue's terrible triad study. A review of all arthroscopically confirmed acute injuries of second degree or worse to the ACL and MCL was performed. Of the 52 knees reviewed, 80% of group 1 had lateral meniscus tears and 29% had associated medial meniscus tears. None of the medial meniscus tears were isolated; medial meniscus tears were not present in the absence of a lateral meniscus tear.〔 From this study, it was concluded that the structures more typically involved in a triad were the anterior cruciate ligament, medial collateral ligament, and the lateral (not medial) meniscus.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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