Skip to main content
Top
Published in: Sports Medicine 3/2019

01-03-2019 | Systematic Review

Bone Bruises Associated with Anterior Cruciate Ligament Injury as Indicators of Injury Mechanism: A Systematic Review

Authors: Liwen Zhang, Jonathon D. Hacke, William E. Garrett, Hui Liu, Bing Yu

Published in: Sports Medicine | Issue 3/2019

Login to get access

Abstract

Background

Anterior cruciate ligament (ACL) injury is one of the most common injuries in sports, and the injury mechanisms are not completely clear. Bone bruises seen on magnetic resonance imaging (MRI) following ACL injuries may provide significant information for determining ACL injury mechanisms.

Objective

The aim was to determine ACL injury mechanisms through an evaluation of locations of bone bruises associated with ACL injury.

Methods

A search for related articles in PubMed and the EBSCO Sport Database was performed using selected search strings from inception to August 6, 2018. Original studies with specified bone bruise locations identified using MRI technology were reviewed.

Results

A total of 12 studies with 589 patients were selected for review. A total of 471 bone bruises in the lateral tibial plateau were reported. Of these bone bruises, 409 (87%) occurred in the posterior section. A total of 242 bone bruises in the medial tibial plateau were reported. Of these bone bruises, 208 (86%) occurred in the posterior section. A total of 266 bone bruises in the lateral femoral condyle were reported. Of these bone bruises, 65 (25%) and 184 (69%) occurred in the anterior and central sections, respectively. A total of 105 bone bruises in the medial femoral condyle were reported. Of these bone bruises, 49 (47%) and 41 (39%) occurred in the anterior and central sections, respectively.

Conclusions

Bone bruise location patterns indicate that tibial anterior translation relative to the femur was a primary injury mechanism in the majority of ACL injuries selected in this review, and that the maximal knee valgus apparently occurred after tibial anterior translation sufficient to injure the ACL. Bone bruise location patterns also indicate knee hyper-extension as another mechanism of non-contact ACL injury.
Literature
5.
go back to reference Griffin LY, Agel J, Albohm MJ, Arendt EA, Dick RW, Garrett WE, et al. Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg. 2000;8(3):141–50.PubMedCrossRef Griffin LY, Agel J, Albohm MJ, Arendt EA, Dick RW, Garrett WE, et al. Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg. 2000;8(3):141–50.PubMedCrossRef
9.
go back to reference Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train. 2007;42(2):311–9.PubMedPubMedCentral Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train. 2007;42(2):311–9.PubMedPubMedCentral
11.
go back to reference Mink JH, Deutsch AL. Occult cartilage and bone injuries of the knee: detection, classification, and assessment with MR imaging. Radiology. 1989;170(3):823–9.PubMedCrossRef Mink JH, Deutsch AL. Occult cartilage and bone injuries of the knee: detection, classification, and assessment with MR imaging. Radiology. 1989;170(3):823–9.PubMedCrossRef
13.
go back to reference Vellet AD, Marks PH, Fowler PJ, Munro TG. Occult posttraumatic osteochondral lesions of the knee: prevalence, classification, and short-term sequelae evaluated with MR imaging. Radiology. 1991;178(1):271–6.PubMedCrossRef Vellet AD, Marks PH, Fowler PJ, Munro TG. Occult posttraumatic osteochondral lesions of the knee: prevalence, classification, and short-term sequelae evaluated with MR imaging. Radiology. 1991;178(1):271–6.PubMedCrossRef
14.
go back to reference Lynch TC, Crues JV 3rd, Morgan FW, Sheehan WE, Harter LP, Ryu R. Bone abnormalities of the knee: prevalence and significance at MR imaging. Radiology. 1989;171(3):761–6.PubMedCrossRef Lynch TC, Crues JV 3rd, Morgan FW, Sheehan WE, Harter LP, Ryu R. Bone abnormalities of the knee: prevalence and significance at MR imaging. Radiology. 1989;171(3):761–6.PubMedCrossRef
16.
go back to reference Sanders TG, Medynski MA, Feller JF, Lawhorn KW. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics. 2000;20(1):S135–51.PubMedCrossRef Sanders TG, Medynski MA, Feller JF, Lawhorn KW. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics. 2000;20(1):S135–51.PubMedCrossRef
17.
go back to reference Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. Am J Sports Med. 2013;41(8):1801–7.PubMedCrossRef Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. Am J Sports Med. 2013;41(8):1801–7.PubMedCrossRef
19.
go back to reference Westermann RW, Wolf BR, Wahl CJ. Does lateral knee geometry influence bone bruise patterns after anterior cruciate ligament injury? A report of two cases. Iowa Orthop J. 2013;33:217–20.PubMedPubMedCentral Westermann RW, Wolf BR, Wahl CJ. Does lateral knee geometry influence bone bruise patterns after anterior cruciate ligament injury? A report of two cases. Iowa Orthop J. 2013;33:217–20.PubMedPubMedCentral
20.
go back to reference Wittstein J, Vinson E, Garrett W. Comparison between sexes of bone contusions and meniscal tear patterns in noncontact anterior cruciate ligament injuries. Am J Sports Med. 2014;42(6):1401–7.PubMedCrossRef Wittstein J, Vinson E, Garrett W. Comparison between sexes of bone contusions and meniscal tear patterns in noncontact anterior cruciate ligament injuries. Am J Sports Med. 2014;42(6):1401–7.PubMedCrossRef
22.
go back to reference Driban JB, Lohmander S, Frobell RB. Posttraumatic bone marrow lesion volume and knee pain within 4 weeks after anterior cruciate ligament injury. J Athl Training. 2017;52(6):575–80.CrossRef Driban JB, Lohmander S, Frobell RB. Posttraumatic bone marrow lesion volume and knee pain within 4 weeks after anterior cruciate ligament injury. J Athl Training. 2017;52(6):575–80.CrossRef
35.
go back to reference Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR. Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. Radiology. 1999;211(3):747–53.PubMedCrossRef Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR. Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. Radiology. 1999;211(3):747–53.PubMedCrossRef
37.
go back to reference Lee K, Siegel MJ, Lau DM, Hildebolt CF, Matava MJ. Anterior cruciate ligament tears: MR imaging-based diagnosis in a pediatric population. Radiology. 1999;213(3):697–704.PubMedCrossRef Lee K, Siegel MJ, Lau DM, Hildebolt CF, Matava MJ. Anterior cruciate ligament tears: MR imaging-based diagnosis in a pediatric population. Radiology. 1999;213(3):697–704.PubMedCrossRef
38.
go back to reference Snearly WN, Kaplan PA, Dussault RG. Lateral-compartment bone contusions in adolescents with intact anterior cruciate ligaments. Radiology. 1996;198(1):205–8. Snearly WN, Kaplan PA, Dussault RG. Lateral-compartment bone contusions in adolescents with intact anterior cruciate ligaments. Radiology. 1996;198(1):205–8.
Metadata
Title
Bone Bruises Associated with Anterior Cruciate Ligament Injury as Indicators of Injury Mechanism: A Systematic Review
Authors
Liwen Zhang
Jonathon D. Hacke
William E. Garrett
Hui Liu
Bing Yu
Publication date
01-03-2019
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 3/2019
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-019-01060-6

Other articles of this Issue 3/2019

Sports Medicine 3/2019 Go to the issue