Increased bone tracer uptake in symptomatic patients with ACL graft insufficiency: a correlation of MRI and SPECT/CT findings

Mathis, Dominic T.; Hirschmann, Anna; Falkowski, Anna L.; Kiekara, Tommi; Amsler, Felix; Rasch, Helmut; Hirschmann, Michael T.

doi:10.1007/s00167-017-4588-5

Cited by 13 publications

(5 citation statements)

References 59 publications

(95 reference statements)

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“…In most of the previous studies, MRI was used for morphological evaluation based on the MOCART scoring system [45]. To our knowledge, only few authors have compared MRI and SPECT/CT in patients after knee surgery [9, 24, 42, 43, 46]. It is a pertinent question what the pathophysiology behind BTU in SPECT/CT and bone oedema in MRI is and whether these represent similar or different windows into the underlying pathology.…”

Section: Discussionmentioning

confidence: 99%

Good clinical results but moderate osseointegration and defect filling of a cell-free multi-layered nano-composite scaffold for treatment of osteochondral lesions of the knee

Mathis

Kaelin

Rasch

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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Section: Discussionmentioning

confidence: 99%

Good clinical results but moderate osseointegration and defect filling of a cell-free multi-layered nano-composite scaffold for treatment of osteochondral lesions of the knee

Mathis

Kaelin

Rasch

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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“…Moreover, histological studies allowed to correlate these MRI findings to tissue alterations, including microfracture of the subarticular spongiosa, with osteocyte necrosis and empty lacunae, bleeding in the fatty marrow and edema [55, 62]. Bone bruise associated with ACL rupture has been extensively investigated [62, 63], but several aspects remain controversial and await evidence on how this MRI finding should be managed while addressing the ligament lesion.…”

Section: Introductionmentioning

confidence: 99%

Bone bruise in anterior cruciate ligament rupture entails a more severe joint damage affecting joint degenerative progression

Filardo

Andriolo

Frattura

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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Purpose During anterior cruciate ligament (ACL) injury, the large external forces responsible for ligament rupture cause a violent impact between tibial and femoral articular cartilage, which is transferred to bone resulting in bone bruise detectable at MRI. Several aspects remain controversial and await evidence on how this MRI finding should be managed while addressing the ligament lesion. Thus, the aim of the present review was to document the evidence of all available literature on the role of bone bruise associated with ACL lesions. Methods A systematic review of the literature was performed on bone bruise associated with ACL injury. The search was conducted in September 2017 on three medical electronic databases: PubMed, Web of Science, and the Cochrane Collaboration. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were used. Relevant articles were studied to investigate three main aspects: prevalence and progression of bone bruise associated with ACL lesions, its impact on the knee in terms of lesion severity and joint degeneration progression over time and, finally, the influence of bone bruise on patient prognosis in terms of clinical outcome. Results The search identified 415 records and, after an initial screening according to the inclusion/exclusion criteria, 83 papers were used for analysis, involving a total of 10,047 patients. Bone bruise has a high prevalence (78% in the most recent papers), with distinct patterns related to the mechanism of injury. This MRI finding is detectable only in a minority of cases the first few months after trauma, but its presence and persistence have been correlated to a more severe joint damage that may affect the degenerative progression of the entire joint, with recent evidence suggesting possible effects on long-term clinical outcome. Conclusion This systematic review of the literature documented a growing interest on bone bruise associated with ACL injury, highlighting aspects which could provide to orthopaedic surgeons evidence-based suggestions in terms of clinical relevance when dealing with patients affected by bone bruise following ACL injury. However, prospective long-term studies are needed to better understand the natural history of bone bruise, identifying prognostic factors and targets of specific treatments that should be developed in light of the overall joint derangements accompanying ACL lesions. Levels of evidence IV, Systematic review of level I-IV studies.

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“…Whereas CT component delivers information on alignment, the SPECT component gives information on bone physiology. Several studies have shown that increased bone tracer uptake (BTU) reflects areas of increased in-vivo loading and BTU patterns for different problems have been detected [ 12 , 13 , 14 , 15 , 16 ]. Knees suffering from posterior instability cause the tibia to shift backwards due to PCL insufficiency which increases the pressure on the patella and patients report of knee pain.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Algorithm in Patients with Flexion Instability after Cruciate-Retaining Total Knee Arthroplasty: A Case Report

Moser

Prabhakar

Hess

et al. 2021

Clinics and Practice

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A posterior flexion instability due to insufficiency of the posterior cruciate ligament (PCL) in cruciate retaining (CR) total knee arthroplasty (TKA) is an important but underdiagnosed problem. We hereby suggest a diagnostic algorithm, as demonstrated by a case report of a male patient suffering from anterior knee pain and instability after CR TKA. Clinical examination was followed by standard anterior–posterior and lateral radiographs. Stress radiographs in 30° and 90° posterior drawer position enabled a dynamic examination of the instability. SPECT/CT was used to determine the TKA component position in all planes and investigate bone tracer uptake (BTU) patterns. At revision surgery, an absent PCL after CR TKA was noted and a semi-constrained TKA was implanted.

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Increased bone tracer uptake in symptomatic patients with ACL graft insufficiency: a correlation of MRI and SPECT/CT findings

Abstract: Retrospective cohort study, Level III.

Cited by 13 publications

References 59 publications

Good clinical results but moderate osseointegration and defect filling of a cell-free multi-layered nano-composite scaffold for treatment of osteochondral lesions of the knee

Good clinical results but moderate osseointegration and defect filling of a cell-free multi-layered nano-composite scaffold for treatment of osteochondral lesions of the knee

Bone bruise in anterior cruciate ligament rupture entails a more severe joint damage affecting joint degenerative progression

Diagnostic Algorithm in Patients with Flexion Instability after Cruciate-Retaining Total Knee Arthroplasty: A Case Report

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