"Bone bruises" on magnetic resonance imaging evaluation of anterior cruciate ligament injuries

Graf, Ben K.; Cook, Dave; Smet, Arthur A. De; Keene, James S.

doi:10.1177/036354659302100210

Cited by 203 publications

(147 citation statements)

References 11 publications

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“…ACL tears are associated with at least one bone bruise in 71% of patients, and most commonly involve the midportion of the lateral femoral condyle near the terminal sulcus and the posterior lateral tibial plateau [5]. Our incidence of bone bruises was even higher (88.6%).…”

Section: Discussionmentioning

confidence: 73%

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

Halinen

Koivikko

Lindahl

et al. 2008

International Orthopaedics (SICOT)

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This study compares MRI with examination under anaesthesia to surgical findings in evaluating soft tissue injuries in acute multi-ligament knee trauma. Preoperative MRI was done for 44 patients who underwent surgery for grade III ACL and grade III medial collateral ligament (MCL) injury. In 21 cases both ACL and MCL were treated surgically, but in 23 only ACL. Intra-operative and MRI findings were compared. Accuracy of MRI for medial meniscal tears was 88.6%, sensitivity 80%, and specificity 91.2%; accuracy for lateral meniscal tears was 72.7%, sensitivity 55% and specificity 87.5%. Accuracy and sensitivity for severity of ACL tear was 93.2% and of MCL tear 86.4%. In 88.6% of the knees, bone bruises were visible, with anterolateral femoral and posterolateral tibial bone bruise being the most common. MRI revealed no chondral lesion, but arthroscopy revealed 11. In combined ACL-MCL ruptures, the incidence of concomitant injuries is high and the injuries are best detected with MRI.

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Section: Discussionmentioning

confidence: 73%

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

Halinen

Koivikko

Lindahl

et al. 2008

International Orthopaedics (SICOT)

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“…The presence of bone bruises was first described by Mink et al [175] after reviewing MRI of the knee associated with medial collateral ligament (MCL) injuries. Mink et al [176] later reported that bone bruises in the lateral femoral condyle and/or lateral tibial plateau were observed in 72% of ACL injured knees, and this finding has been confirmed by other researchers [177][178][179][180][181][182][183][184][185][186][187]. Histological changes in the articular cartilage overlying a geographic bone bruise demonstrated significant injury to the homeostasis of the articular cartilage over the bone [183].…”

Section: Mri Analysesmentioning

confidence: 68%

The Mechanism of Non-contact Anterior Cruciate Ligament Injury in Female Athletes: Is the Injury Mechanism Different between the Genders?

Gamada¹,

Kubota²

2014

Int J Phys Med Rehabil

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ACL injury is one of the most frequent and costly injuries in sports, and is a major risk factor for early knee osteoarthritis. Although female gender is a major risk factor for ACL injury, differences in the injury mechanism between males and females have not yet been determined. The goal of this review was to determine whether there is any evidence of gender differences in the mechanisms of ACL injury. MRI studies demonstrated that the location of bone bruises after ACL injury was similar between genders and that males demonstrated more extensive damage in the joint, suggesting the involvement of higher energy but not a difference in injury mechanism. Video analyses of the process of ACL injury has shown common body positions at the time of injury, but failed to reveal differences in the joint motions between genders. Therefore, the mechanism of ACL injury is likely to be similar across genders.

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“…Bone 'bruises', sustained at the time of injury, may perhaps damage the subchondral bone (Graf et al 1993;Fowler 1994). Even the geometry of the femoral condyle has been evoked (Friden et al 1993).…”

Section: Discussionmentioning

confidence: 99%

Non-Operative Management of Anterior Cruciate Ligament Injuries in the General Population

Casteleyn

Handelberg

1996

The Journal of Bone and Joint Surgery. British volume

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The operative treatment of lesions of the anterior cruciate ligament (ACL) in athletes has been widely advocated and performed. We have investigated the outcome of non-operative management in a lowerdemand, general population. We reviewed a consecutive group of 228 patients, which excluded professional and high-level athletes, for two to 12 years after an ACL lesion had been diagnosed by arthroscopy.There was a low incidence of secondary ACL and meniscal surgery, 5.4% and 3.5% respectively, and all these procedures were performed during the first three years after the ACL injury.We studied a subgroup of 109 patients with follow-up of at least five years (mean 8.5 years) and evaluated them using the IKDC score. The general outcome was reasonably satisfactory, with 23% in grade A, 50% in grade B, 21% in grade C and only 6.4% in grade D. We found no statistically significant prognostic effect within this group as regards age, activity levels, or the incidence of associated lesions.J Bone Joint Surg [Br] ] 1996;78-B:446-51. Received 25 August 1995; Accepted after revision 29 November 1995Lesions of the anterior cruciate ligament (ACL) in athletes have been studied extensively in orthopaedic sports medicine, and operative treatment using grafts is widely advocated for this particular group of patients (Fetto and Marshall 1980;Noyes et al 1983a;Kannus and Järvinen 1987;Andersson et al 1989;Barrack et al 1990;Daniel and Fithian 1994). Many ACL lesions, however, are seen in nonathletes as a result of accidents or low-grade recreational activities (Jain, Swanson and Murdoch 1983;Casteleyn, Handelberg and Opdecam 1988). We aimed to investigate the outcome of the conservative treatment of ACL lesions in a lower-demand population. PATIENTS AND METHODSOver a period of 12 years, we managed a total of 274 patients with acute traumatic knee haemarthrosis. All had examination under anaesthesia and arthroscopy.Of these, we treated 46 by ACL reconstruction. They included patients with gross or multidirectional joint laxity (grade-3 or grade-4 pivot shift, combined lesions of the ACL and lateral collateral ligament (LCL) or posterior cruciate ligament (PCL)) and in addition all high-level or professional athletes. These 46 cases (16.8%) were excluded from the study group.This left a consecutive group of 228 patients (83%) who were managed conservatively. There was an almost fourfold male to female ratio and the mean age at the time of injury was 33.2 years (16 to 66). The main causes of injury were daily living activities (28.1%), traffic accidents (11.8%), and recreational activities (60.1%) ( Table I). Initial management. In 83% of the cases, arthroscopic evaluation was within three weeks of the index injury. The proportions of isolated ACL ruptures and those associated with meniscal and ligamentous lesions were comparable with those reported in previous studies (Casteleyn et al 1988) (Tables I and II); only 21 of the ACL tears (9%) were partial. Intrasynovial ACL lesions (14; 6.1%) were left as much as possible within the synov...

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"Bone bruises" on magnetic resonance imaging evaluation of anterior cruciate ligament injuries

Cited by 203 publications

References 11 publications

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

The efficacy of magnetic resonance imaging in acute multi-ligament injuries

The Mechanism of Non-contact Anterior Cruciate Ligament Injury in Female Athletes: Is the Injury Mechanism Different between the Genders?

Non-Operative Management of Anterior Cruciate Ligament Injuries in the General Population

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