head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2024, vol. 30, issue1
Subject Area: Public Health
DOI: 10.5272/jimab.2024301.5361
Published online: 12 February 2024

Original article
J of IMAB. 2024 Jan-Mar;30(1):5361-5364
Mariya GramatikovaORCID logoCorresponding Autoremail,
Department of Kinesitherapy, Faculty of Public Health, Healthcare and Sports, South-West University "Neofit Rilski", Blagoevgrad, Bulgaria.

The term "Unhappy Triad", coined by O'Donoghue, reflects a severe knee injury with rupture of the medial collateral ligament, medial meniscus, and anterior cruciate ligament. The triad is primarily a sports injury, and patients' recovery is 6 to 12 months.
Material/Methods: 70 patients with "O'Donoghue's triad" were studied. Total anterior cruciate ligament rupture was reconstructed with patellae ligament autograft; medial meniscus tear was treated with partial meniscectomy; and medial collateral ligament injury was treated conservatively at 1 month before surgery.
The aim of the study is to establish the epidemiology of the injury: age and gender distribution, distribution by types of sports in patients with "O'Donoghue's Triad" after arthroscopic treatment. 222 persons were examined in two stages – first, 187 with various soft tissue injuries of the knee, after surgical treatment, including persons with the triad, and second, 70 patients with O'Donoghue's triad.
Results: The study shows that among 18-19-year-olds, the triad was found in 4 people; from 20 to 29 in 34, from 30 to 39 in 23, and from 40 to 49 in 9. In terms of gender, there were 62 men (86.11%) and 8 women (13.89%) with the triad injury. "O'Donoghue's Triad" was obtained during sports in 91.52% of cases, the remaining 8.48% in car accidents and household accidents.
Conclusions: The results of the study establish and provide coaches, physiotherapists, orthopedists, scientists and educators with up-to-date data on the epidemiology of O'Donoghue's Triad, its incidence, age and sex characteristics and its distribution by sport.

Keywords: knee, "Unhappy Triad", ACL, MCL, meniscus, physiotherapy,

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Please cite this article as: Gramatikova M. Epidemiology of “O’Donoghue’s Triad”. J of IMAB. 2024 Jan-Mar;30(1):5361-5364. [Crossref - 10.5272/jimab.2024301.5361]

Corresponding AutorCorrespondence to: Assoc. Prof. Mariya Gramatikova, PhD, Department of Kinesitherapy, Faculty of Public Health, Healthcare and Sports, South-West University "Neofit Rilski"; 66. Ivan Mihaylov Str., 2700 Blagoevgrad, Bulgaria; E-mail: mari_gramatikova@abv.bg

1. Gramatikova M. Diagnostic system for functional assessment of patients with the O’Donoghue triad. KNOWLEDGE - Int J. 2021 Aug;47(4):705–710. [Internet ]
2. O'Donoghue D. The Unhappy triad: etiology, diagnosis and treatment. Am J Orthop. 1964 Nov-Dec;6:242-7 PASSIM. [PubMed ]
3. Barber FA. What is the terrible triad? Arthroscopy. 1992; 8(1):19-22. [PubMed]
4. Reer R, Nagel V, Paul B, Edelmann H, Braumann KM. [The application of external knee stabilizers - Influence on mechanical stabilization and physical performance]. [in German] Sportverletz Sportschaden. 2001 Sep;15(3):62-7. [PubMed]
5. Shivachev Y, Bogomilova S. Prevention tools in the area of the knee complex - treatment and prophylaxis. J of IMAB. 2020 Apr-Jun;26(2):3160-3162. [Crossref]
6. Avramova M, Mitova St, Karashtranova E, Georgieva D. Examining the relationship between pain intensity, functional disability and range of movement using TECAR therapy in athletes after anterior cruciate ligament reconstruction. JPES. 2023 Oct;23(10):2728-2736. [Crossref]
7. Zlatkova Kr, Zlatkov Y. ERGON Technique for the therapy of a Plica syndrome. J of IMAB. 2022; 28(Supplement3):47-49. [Crossref]
8. Gramatikova M, Valchev N. Soft tissue mobilization after surgical treatment of "O'Donoghue's Triad". J of IMAB. 2022; 28(Supplement3):69-72. [Crossref]
9. Gramatikova M, Petrov B, Pacheva P, Gramatikova V. Recovery of the active flexion of the knee joint after" O'Donoghue's triad". Sport Science. 2016; 9(1):55-58. [Internet]
10. Posch M, Schranz A, Lener M, Tecklenburg K, Burtscher M, Ruedl G. In recreational alpine skiing, the ACL is predominantly injured in all knee injuries needing hospitalization. Knee Surg Sports Traumatol Arthrosc. 2021 Jun;29(6):1790-1796. [PubMed ]
11. Bakshi NK, Khan M, Lee S, Finney FT, Stotts J, Sikka RS, et al. Return to Play After Multiligament Knee Injuries in National Football League Athletes. Sports Health. 2018 Nov/Dec;10(6):495-499. [PubMed]
12. Glushkova M, Popova D, Glushkov Iv, Gramatikova M. The phenomenon of "CONCORDANCE" in children's psychological and physical development. Activities in Physical Education & Sport. 2014;4(1):44-49.
13. Gramatikova M. [Kinesitherapy with dynamic knee joint instability.] [monograph] University publishing house "Neofit Rilski", Blagoevgrad; 2017. 205 p. [in Bulgarian]

Received: 09 July 2023
Published online: 12 February 2024

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