Bone bruise in the acutely injured knee

Bretlau, Thomas; Tuxøe, Jon; Larsen, Lis Olesen; Jørgensen, U. G.; Thomsen, Henrik S.; Lausten, Gunnar Schwarz

doi:10.1007/s00167-001-0272-9

Cited by 115 publications

(83 citation statements)

References 20 publications

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“…Our present study also showed that most BMELs had resolved at 6 months after ACL reconstruction and only 22.2% remained at that time-point, and even a smaller portion (6.5%) could be seen at 2 years followup MR imaging. The rapid resolution of BMELs over time in this study was similar to what other studies have reported (39,40). Nine new BMELs in six injured knees (16.2%) were detected in the course of the 2-year followup (3 at 6-month, 4 at 1-year and 2 at 2-year).…”

Section: Discussionsupporting

confidence: 92%

Bone marrow edema-like lesions (BMELs) are associated with higher T1ρ and T2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study

Gong

Pedoia

Facchetti

et al. 2016

Quant. Imaging Med. Surg.

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Background: To evaluate the longitudinal changes of bone marrow edema-like lesions (BMELs) in patients after anterior cruciate ligament (ACL) reconstruction and to investigate the effect of BMELs on cartilage matrix composition changes measured using MR T 1ρ and T 2 mapping. Methods:Patients with acute ACL tear were enrolled in a prospective study. MR imaging was performed at baseline (before surgeries) and at 6-month, 1-year and 2-year after ACL reconstruction. MR imaging included sagittal high-resolution, 3D fast spin-echo (CUBE) sequences for BMEL evaluation, and 3D T 1ρ mapping and T 2 mapping for cartilage assessment. BMELs were assessed using whole-organ magnetic resonance imaging score (WORMS), and the volume of BMELs was measured by a semi-automatic method.Generalized estimating equation (GEE) was used to explore association between BMELs at baseline and cartilage changes during follow-up.Results: Fifty four patients were included in the present study and 39 patients had completed 2-year follow-up. BMELs were noted in 42 injured knees (77.8%) with 105 lesions and in 7 contralateral knees (13.0%) with 9 lesions (χ 2 =45.763, P<0.001) at the baseline. The WORMS and volume of BMELs of the injured knees were 2.36±0.65 and 386.98±382.54 mm 3 (r=0.681, P<0.001), respectively. 87 BMELs were found at baseline in 34 patients (87.2%) of the 39 patients who had completed 2 years follow-up. During the follow-up, 18 (20.7%), 12 (13.8%), and 5 (5.7%) baseline lesions were still seen at 6-month, 1-year and 2-year, respectively. The changes of BMELs prevalence regarding bone compartments over time points were statistically significant (χ 2 =163.660, P<0.001). Except T 2 value at 6 months, T 1ρ and T 2 values of cartilage overlying baseline BMELs in the injured knees were higher than that of anatomically matched cartilage in the contralateral knees at baseline and each follow-up time-point. In the injured knees, GEE analysis showed that baseline BMELs were significantly associated with higher T 1ρ and T 2 values of cartilage after adjustment of age, gender, body mass index (BMI), effusion and meniscus tear. The association between BMELs and Knee Injury and Osteoarthritis Outcome Scores (KOOS) scores was not statistically significant.Conclusions: BMEL is a common finding in patients with acute ACL injury and resolves rapidly over time after ACL reconstruction. It is often associated with increased T 1ρ and T 2 values of cartilage. BMEL at baseline is an independent predictor for faster cartilage degeneration during follow-up.

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Section: Discussionsupporting

confidence: 92%

Bone marrow edema-like lesions (BMELs) are associated with higher T1ρ and T2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study

Gong

Pedoia

Facchetti

et al. 2016

Quant. Imaging Med. Surg.

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“…The ill-defined low T1 and corresponding high T2 signal on MRI is similar to stress reactions, but can be differentiated by patient history, physical examination findings (overlying ecchymosis), surrounding soft tissue edema on MRI, and location of the marrow abnormality [14]. Extrapolating from a study of knee contusion marrow edema, marrow signal abnormality in hip contusions may be seen as early as 1 h, and more reliably at 6 h, post injury [15] and may persist up to 4 months, as was seen in nearly 70 % of patients in another study [16].…”

Section: Contusionmentioning

confidence: 94%

MRI of the Hip: Important Injuries of the Adult Athlete

et al. 2014

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Hip pain is a common problem in adult athletes and may be caused by a wide range of acute and chronic injuries, many of which lead to prolonged time away from sport. This article highlights the magnetic resonance imaging (MRI) findings of important hip injuries in adult athletes, including select osseous, impingement, intraarticular, and musculotendinous injuries. The most commonly affected athletes, clinical presentation, and MRI findings of each injury are reviewed with corresponding clinical pearls from the orthopedist's perspective.

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“…A recent study by Boks et al suggests that, contrary to expectations, reticular post traumatic BMLs are not associated with increased pain severity in posttraumatic knees 25 . Simple post-traumatic BMLs without involvement of the articular surface are thus likely to be benign occurrences 26,27 . As such, post-traumatic BMLs generally resolve without sequelae within 6-12 months following the injury, though new BMLs have been shown to develop in approximately one-third of ACL-injured knees over the first two years post-injury [26][27][28] .…”

Section: Post-traumatic Bone Marrow Lesionsmentioning

confidence: 99%

The Health and Structural Consequences of Acute Knee Injuries Involving Rupture of the Anterior Cruciate Ligament

Riordan

Frobell

Roemer

et al. 2013

Rheumatic Disease Clinics of North America

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Word Count: 4183 2 3 SynopsisAlthough there is an abundance of literature regarding the development of knee osteoarthritis following rupture of the anterior cruciate ligament (ACL), the exact mechanism underlying this link is still not clear.Recent studies have reported that a number of factors may be predictive of the subsequent development of osteoarthritis, with damage to the menisci and articular cartilage during the initial trauma, altered knee biomechanics post-injury, and episodic instability chief among them. This article summarizes recent developments in the understanding of the joint damage resulting from an ACL tear, and the influence that current and future treatment methods may have on the long-term progression to osteoarthritis.

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Bone bruise in the acutely injured knee

Cited by 115 publications

References 20 publications

Bone marrow edema-like lesions (BMELs) are associated with higher T1ρ and T2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study

Bone marrow edema-like lesions (BMELs) are associated with higher T1ρ and T2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study

MRI of the Hip: Important Injuries of the Adult Athlete

The Health and Structural Consequences of Acute Knee Injuries Involving Rupture of the Anterior Cruciate Ligament

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