{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:03:14Z","timestamp":1787961794123,"version":"build-2784847793"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>There has been a continued effort to better understand the role Kaplan fiber injury plays in persistent instability following ACL tears. However, the prevalence of these injuries remains poorly understood. Therefore, the purpose of this study was to define the prevalence of Kaplan fiber injury in the setting of complete anterior cruciate ligament tear using a commonly used grading system for assessing ligament injuries. The inter\u2010rater reliability of this commonly used grading system and the relationship between Kaplan fiber injury and injury to other structures commonly found in conjunction with ACL tears was also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All isolated, complete anterior cruciate ligament tears confirmed on magnetic resonance imaging within 90\u00a0days of injury between 2014 and 2020 at a single institution were included for analysis. Each scan was read by two, fellowship\u2010trained musculoskeletal radiologists. Kaplan fiber injury was evaluated using a previously described grading scheme. Kappa, <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/ksabf07790-math-0001.png\" xlink:title=\"urn:x-wiley:09422056:media:ksabf07790:ksabf07790-math-0001\"\/>, of inter\u2010rater agreement was determined for all magnetic resonance image scans. Kruskal Wallis test was performed to assess for associations between Kaplan fiber injury and magnet strength (1.5 T vs. 3.0 T), patient gender, the presence of medial and\/or lateral meniscal tears, and\/or posterolateral tibial bone bruise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2014 and 2020, 131 patients (94\u00a0males, 37 females) with a complete anterior cruciate ligament tear were included in the final analysis. The mean age of the cohort was 27.8\u2009\u00b1\u20096.8 years. Kaplan fiber injuries were identified in 51 of 131 (38.9%, CI 31.0\u201347.5%) scans with complete anterior cruciate ligament injuries (Grade 1: 28, Grade 2: 18, and Grade 3: 5). Inter\u2010rater agreement for Kaplan fiber injury was fair (<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/ksabf07790-math-0003.png\" xlink:title=\"urn:x-wiley:09422056:media:ksabf07790:ksabf07790-math-0003\"\/> with 43 (32.8%) scans requiring third reviewer adjudication. There were no significant associations between Kaplan fiber injury and gender, magnet strength, meniscal tears, or posterolateral tibial bone bruise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The prevalence of Kaplan fiber injuries was comparable to previously described rates; however, the classification system used to report Kaplan fiber injury was associated with low inter\u2010rater reliability. The presence of Kaplan fiber injury was not associated with other injuries commonly observed in conjunction with ACL tear. The previously proposed Kaplan fiber injury classification system is not reproducible nor is it likely to aid surgeons in distinguishing higher grades of rotatory knee instability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06730-5","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T15:22:00Z","timestamp":1631632920000},"page":"1769-1775","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Magnetic resonance imaging does not reliably detect Kaplan fiber injury in the setting of anterior cruciate ligament tear"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4970-8088","authenticated-orcid":false,"given":"Thomas B.","family":"Lynch","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> San Antonio Military Medical Center 3551 Roger Brooke Road 78234 San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy M.","family":"Bernot","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> San Antonio Military Medical Center 3551 Roger Brooke Road 78234 San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Oettel","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> San Antonio Military Medical Center 3551 Roger Brooke Road 78234 San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Byerly","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> San Antonio Military Medical Center 3551 Roger Brooke Road 78234 San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Musahl","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Chasteen","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Uniformed Health Services University Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan J.","family":"Antosh","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> San Antonio Military Medical Center 3551 Roger Brooke Road 78234 San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne C.","family":"Patzkowski","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> San Antonio Military Medical Center 3551 Roger Brooke Road 78234 San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Sheean","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> San Antonio Military Medical Center 3551 Roger Brooke Road 78234 San Antonio TX 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