Bone Bruise Distribution Patterns After Acute Anterior Cruciate Ligament Ruptures: Implications for the Injury Mechanism

Shi, Huijuan; Jiang, Yanfang; Zhang, Haocheng; Ren, Shuang; Hu, Xiaoqing; Liu, Zhenlong; Huang, Hongshi; Ao, Yingfang

doi:10.1177/2325967120911162

Cited by 30 publications

(72 citation statements)

References 38 publications

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“…We found that kissing contusions occurred more commonly in the posterior aspect of the tibial plateau and the femoral condyle's central aspect. Consistent with previous studies (2,17), lateral femoral condyle's most common pattern in patients with LKCs was the centrallateral. Previous studies have reported that tibial bone contusions occur in the posterior section.…”

Section: Discussionsupporting

confidence: 90%

“…The severity and the location patterns of tibiofemoral bone contusions observed on the magnetic resonance imaging scans may result from joint impact at the time of anterior cruciate ligament injury and could provide important information about anterior cruciate ligament injury mechanisms (6,17,20,21). Previous studies have investigated the mechanisms of anterior cruciate ligament injuries using patterns of kissing bone contusions.…”

Section: Discussionmentioning

confidence: 99%

“…As bone contusions were more serious on the lateral section, the valgus was considered the primary injury mechanism (6). Other studies have reported that an anterior translation of the tibia relative to the femur with a small knee flexion angle may be the primary mechanism of an anterior cruciate ligament injury based on the observed bone contusions on the posterior tibia and anterior femur (2,17). Further, the effects of the lateral translation of the tibia on anterior cruciate ligament injury has gradually attracted attention (24,25).…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that bone contusions observed on magnetic resonance imaging scans in the tibia and femur are secondary signs for detecting other associated abnormalities and the mechanisms of injury (13)(14)(15)(16). The degree of bone contusions may relate to the amount of energy imparted on the knee during the injury (6,17). Comprehensive investigations into the precise location and severity of the bone contusions may increase understanding of anterior cruciate ligament injury mechanisms and assist in the development of more appropriate and effective preventative measures.…”

Section: Mechanisms Of Non-contact Anterior Cruciate Ligament Injury As Determined By Bone Contusion Location and Severitymentioning

confidence: 99%

“…Kissing contusions are defined as relative bone contusion patterns in the tibia and femur and have been the focus of research into anterior cruciate ligament injury mechanisms (18). A recent study on the location of bone contusions in the anterior-posterior direction found that the anterior translation of the tibia relative to the femur occurs during anterior cruciate ligament injury (17). In addition, the lateral femoral condyle and lateral tibial plateau were found to be more common in patients with non-contact anterior cruciate ligament injuries than those with contact injuries (6).…”

Section: Mechanisms Of Non-contact Anterior Cruciate Ligament Injury As Determined By Bone Contusion Location and Severitymentioning

confidence: 99%

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Mechanisms of non-contact anterior cruciate ligament injury as determined by bone contusion location and severity

Qiu

Sheng

et al. 2021

Quant Imaging Med Surg

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Background: The location and severity of tibiofemoral bone contusions in magnetic resonance imaging scans in patients with acute non-contact anterior cruciate ligament injuries can reflect the primary mechanisms of anterior cruciate ligament injuries. There has been limited investigation to subdividing the bone contusion model in the medial and lateral directions of the tibial plateau and the femoral condyle.Methods: A retrospective review of 93 consecutive magnetic resonance imaging examinations of patients with acute non-contact anterior cruciate ligament injuries was conducted to identify bone contusions of the knee. The locations and the severity of the bone contusions were determined using magnetic resonance imaging scans for each anatomic site, including the lateral femoral condyle, the lateral tibial plateau, the medial femoral condyle, and the medial tibial plateau. The bone contusions in the lateral-medial and anteriorposterior directions of four anatomical sites were subdivided into six compartments. The severity of the bone contusions was graded on a scale of 1-4. The location and the severity of bone contusions were accessed in the sagittal and coronal planes on the femoral and tibial sides of the knee using the radiology information system. Results:The prevalence of bone contusions on the magnetic resonance imaging scans was as follows: 78.49% on the lateral femoral condyle, 88.17% on the lateral tibial plateau, 49.46% on the medial femoral condyle, and 69.89% on the medial tibial plateau. The most common and severe compartments of the lateral femoral condyle, the lateral tibial plateau, the medial femoral condyle, and the medial tibial plateau were the centrallateral (CL), the posterior-medial (PM), the CL, and the posterior-lateral (PL) compartments, respectively. Conclusions:The location patterns and severity of bone contusions in patients indicated that internal tibial rotation, valgus, and the anterior and lateral translation of the tibia were the primary mechanisms of non-contact anterior cruciate ligament injury.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Mechanisms Of Non-contact Anterior Cruciate Ligament Injury As Determined By Bone Contusion Location and Severitymentioning

confidence: 99%

Section: Mechanisms Of Non-contact Anterior Cruciate Ligament Injury As Determined By Bone Contusion Location and Severitymentioning

confidence: 99%

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Mechanisms of non-contact anterior cruciate ligament injury as determined by bone contusion location and severity

Qiu

Sheng

et al. 2021

Quant Imaging Med Surg

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Bone bruise distribution predicts anterior cruciate ligament tear location in non‐contact injuries

Ubl,

Vieider,

Seilern und Aspang

et al. 2024

J. exp. orthop.

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PurposeIt is unclear whether different injury mechanisms lead to divergent anterior cruciate ligament (ACL) tear locations. This study aims to analyse the relationship between bone bruise (BB) distribution or depth and ACL tear location.MethodsA retrospective analysis of 446 consecutive patients with acute non‐contact ACL injury was performed. Only patients with complete ACL tears verified during subsequent arthroscopy were included. Magnetic resonance imaging (MRI) was used to classify BB location, BB depth, ACL tear location and concomitant injuries (medial/lateral meniscus and medial/lateral collateral ligament). Demographic characteristics included age, gender, body mass index (BMI), type of sport and time between injury and MRI. Multiple linear regression analysis was used to identify independent predictors of ACL tear location.ResultsOne hundred and fifty‐eight skeletally mature patients met the inclusion criteria. The presence of BB in the lateral tibial plateau was associated with a more distal ACL tear location (β = −0.27, p < 0.001). Less BB depth in the lateral femoral condyle showed a tendency towards more proximal ACL tears (β = −0.14; p = 0.054). Older age predicted a more proximal ACL tear location (β = 0.31, p < 0.001). No significant relationship was found between ACL tear location and gender, BMI, type of sport, concomitant injuries and time between injury and MRI.ConclusionACL tear location after an acute non‐contact injury is associated with distinct patterns of BB distribution, particularly involving the lateral compartment, indicating that different injury mechanisms may lead to different ACL tear locations.Level of EvidenceLevel III.

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Return‐to‐sport quadriceps strength symmetry impacts 5‐year cartilage integrity after anterior cruciate ligament reconstruction: A preliminary analysis

Brunst

Ithurburn

Zbojniewicz

et al. 2021

Journal Orthopaedic Research

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Quadriceps femoris strength asymmetry at the time of return to sports participation after anterior cruciate ligament (ACL) reconstruction contributes to worse function and asymmetric landing patterns, but the impact on longitudinal outcomes is not known. This study determined if young athletes after ACL reconstruction with quadriceps femoris strength asymmetry at a return to sports clearance would demonstrate markers of knee cartilage degeneration 5 years later compared to those with symmetric quadriceps femoris strength at return to sports. Participants (n = 27) were enrolled at the time of medical clearance for sports participation (baseline testing) and followed for 5 years. At baseline, quadriceps femoris strength was measured bilaterally and a limb symmetry index was used to divide the cohort into two groups: return to sport clearance with high quadriceps femoris strength (RTS‐HQ; limb symmetry index ≥ 90%) and return to sport clearance with low quadriceps femoris strength (RTS‐LQ; limb symmetry index < 85%). At 5 years post‐baseline, quantitative magnetic resonance imaging (T2 relaxation times (ms): involved knee medial/lateral femoral condyle and tibial plateau) data were collected. Group differences were evaluated with independent samples t tests. At 5 years post‐return to sports, the RTS‐LQ strength group (n = 14) demonstrated elevated T2 relaxation times at the anterior region of the lateral femoral condyle compared to the RTS‐HQ strength group (n = 13). Clinical Significance: Just over 50% of this cohort was cleared for sports participation with involved limb quadriceps femoris strength deficits that may contribute to early markers of knee cartilage degeneration within the subsequent 5 years.

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Bone Bruise Distribution Patterns After Acute Anterior Cruciate Ligament Ruptures: Implications for the Injury Mechanism

Cited by 30 publications

References 38 publications

Mechanisms of non-contact anterior cruciate ligament injury as determined by bone contusion location and severity

Mechanisms of non-contact anterior cruciate ligament injury as determined by bone contusion location and severity

Bone bruise distribution predicts anterior cruciate ligament tear location in non‐contact injuries

Return‐to‐sport quadriceps strength symmetry impacts 5‐year cartilage integrity after anterior cruciate ligament reconstruction: A preliminary analysis

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