Hyperextension injuries of the knee: do patterns of bone bruising predict soft tissue injury?

Ali, Ayman; Pillai, J. K.; Gulati, Vivek; Gibbons, Charles; Roberton, Benjamin J.

doi:10.1007/s00256-017-2754-y

Cited by 22 publications

(13 citation statements)

References 32 publications

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“…The knee joint relies on a variety of ligaments, muscles, tendons, bones, and cartilage to maintain flexibility, stability, and strength, is the largest and 1 of the most complex joints in the human body . The knee joint is susceptible to many types of injuries, including fractures, sprains, tears, and dislocations . Aging and joint diseases may lead to cartilage degeneration or injury, adversely affecting normal movements of the knee joint …”

Section: Introductionmentioning

confidence: 99%

Diffusion tractography of the rat knee at microscopic resolution

Wang

Mirando

Cofer

et al. 2019

Magnetic Resonance in Med

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Purpose To evaluate whole knee joint tractography, including articular cartilage, ligaments, meniscus, and growth plate using diffusion tensor imaging (DTI) at microscopic resolution. Methods Three rat knee joints were scanned using a modified 3D diffusion‐weighted spin echo pulse sequence with 90‐ and 45‐μm isotropic spatial resolution at 9.4T. The b values varied from 250 to 1250 s/mm2 with 4 times undersampling in phase directions. Fractional anisotropy (FA) and mean diffusivity (MD) were compared at different spatial resolution and b values. Tractography was evaluated at multiple b values and angular resolutions in different connective tissues, and compared with conventional histology. The mean tract length and tract volume in various types of tissues were also quantified. Results DTI metrics (FA and MD) showed consistent quantitative results at 90‐ and 45‐μm isotropic spatial resolutions. Tractography of various connective tissues was found to be sensitive to the spatial resolution, angular resolution, and diffusion weightings. Higher spatial resolution (45 μm) supported tracking the cartilage collagen fiber tracts from the superficial zone to the deep zone, in a continuous and smooth progression in the transitional zone. Fiber length and fiber volume in the growth plate were strongly dependent on angular resolution and b values, whereas tractography in ligaments was found to be less dependent on spatial resolution. Conclusion High spatial and angular resolution DTI and diffusion tractography can be valuable for knee joint research because of its visualization capacity for collagen fiber orientations and quantitative evaluation of tissue’s microscopic properties.

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Section: Introductionmentioning

confidence: 99%

Diffusion tractography of the rat knee at microscopic resolution

Wang

Mirando

Cofer

et al. 2019

Magnetic Resonance in Med

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“…Additionally, most studies have focused on the lateral-medial direction of bone bruise locations, with little attention to the anterior-posterior direction. 1,2,10,19,23,28,31 Further, 2 recent systematic reviews concluded that further studies on bone bruise distribution patterns should be conducted to improve the accuracy of the bone bruise pattern. 25,38 Therefore, the purpose of this study was to investigate the common bone bruise patterns after an ACL injury.…”

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confidence: 99%

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

Shi

Jiang

Zhang

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Bone bruises observed on magnetic resonance imaging (MRI) after an anterior cruciate ligament (ACL) injury could provide significant information about ACL injury mechanisms. Purpose/Hypothesis: The purpose of this study was to investigate common bone bruise patterns after an ACL injury. It was hypothesized that the most common bone bruise distribution pattern would be only the lateral side of both the femur and tibia. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Knee MRI scans of patients who underwent acute ACL reconstruction from August 2016 to August 2018 at our institution were selected. Imaging sequences in the sagittal and coronal planes were used for determining the bone bruise location in the lateral-medial and anterior-posterior directions, respectively. The presence, location, and intensity of bone bruises within specific compartments of the tibia and femur were documented. The relative bone bruise patterns of the tibia and femur were classified and analyzed. Results: A total of 207 patients (165 men, 42 women) met the inclusion criteria from a total of 4209 ACL reconstruction cases. The most common relative bone bruise pattern was located on only the lateral side of both the femur and the tibia (44.4%), followed by the lateral and medial sides of both the femur and tibia (29.0%). For the pattern found on the lateral and medial sides of both the femur and tibia, the bone bruises on only the lateral side of both the tibia and femur were more severe ( P < .001 and P < .001, respectively) and more anterior ( P < .001 and P < .001, respectively) than those on only the medial side. Conclusion: The most common relative bone bruise pattern observed was on only the lateral side of both the tibia and femur. Bone bruises on the lateral side were more severe than those on the medial side in patients with bone bruises on the lateral and medial sides of both the femur and tibia. Anterior translation of the tibia relative to the femur occurred during an ACL injury based on the location of bone bruises in the anterior-posterior direction.

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“…Hyperextension tibial plateau fractures are often accompanied by soft tissue (ligament and meniscus) injuries. Ali et al 18 . reported that 52% of 25 patients with hyperextension injuries were in the posterior joint capsule, 40% had ACL injuries, 20% had meniscus injuries, and 16% had medial and lateral collateral ligament and posterolateral horn injuries.…”

Section: Discussionmentioning

confidence: 99%

Surgical Strategy for Anterior Tibial Plateau Fractures in Hyperextension Knee Injuries

Liu

Zhang

Liu

et al. 2021

Orthopaedic Surgery

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Objective The aim of the present study was to summarize the clinical characteristics, treatment strategies, and clinical results for anterior tibial plateau fractures caused by hyperextension injuries. Methods We performed a retrospective analysis of 26 cases of anterior tibial plateau fractures that were treated with open reduction and internal fixation from January 2016 to December 2019, including 16 men and 10 women, aged 26–68 years old, with an average age of 47 ± 12.5 years. According to the three‐column theory classification, there were 16 cases of single‐column fractures (9 cases of anteromedial fractures and 7 cases of anterolateral fractures), 3 cases of two‐column fractures (anteromedial + anterolateral fractures), and 7 cases of three‐column fractures. Options for the surgical approach included anteromedial, anterolateral, modified anterior median, and anterolateral + posteromedial incision. The implants included a T‐shaped plate, an L‐shaped plate, a horizontal plate, and a TomoFix plate. The surgical approach and fixation method were selected based on the characteristics of the anterior tibial fracture. The Rasmussen radiological criteria were used to evaluate the effects of fracture reduction and fixation. The knee joint function was evaluated using the knee function evaluation criteria of the Hospital for Special Surgery. Medial and lateral stress tests, the Lachman test, and the pivot shift test were used to evaluate the stability of the knee joint. The range of knee motion was recorded. Results All cases were followed up for 12–24 months, with an average follow up of 15.7 months. The operation time was (148 ± 42) min; the intraoperative blood loss was (150 ± 50) mL. A total of 22 cases were anatomically reduced and 4 cases were well‐reduced, and the compression reduction rate was 100%. According to the Rasmussen radiology scoring, 17 cases were excellent and 9 cases were good. The excellent and good rate was 100%. The fracture healing time was 3.3 months. There is no difference in fracture healing time for different fracture types. Both the Lachman and pivot shift test findings were normal in 24 patients and nearly normal in 2 patients. The posterior drawer test was normal in 25 patients and close to normal in 1 patient. The varus stress test was normal in 24 patients and nearly normal in 2 patients, while the valgus stress test was normal in 23 patients, nearly normal in 2 patients, and abnormal in 1 patient. The range of motion (ROM) was 100°–137°, with an average of 125° ± 11.7°. The Hospital for Special Surgery (HSS) knee score at the last follow up was 79–98 points, with an average of 87.54 ± 8.36 points; the results were excellent in 21 cases and good in 5 cases. Therefore, 100% of results were excellent or good. Two cases had superficial wound infections after the operation. The recovery of 2 patients with common peroneal nerve injury was poor. Conclusion The appropriate surgical approach and fixation method were performed according to the different positions of the anterior tibial fractu...

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Hyperextension injuries of the knee: do patterns of bone bruising predict soft tissue injury?

Cited by 22 publications

References 32 publications

Diffusion tractography of the rat knee at microscopic resolution

Diffusion tractography of the rat knee at microscopic resolution

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

Surgical Strategy for Anterior Tibial Plateau Fractures in Hyperextension Knee Injuries

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