Top

Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-11-2019 | Magnetic Resonance Imaging | KNEE

Posterior tibial bone bruising associated with posterior-medial meniscal tear in patients with acute anterior cruciate ligament injury

Authors: Manuel Calvo-Gurry, Eoghan T. Hurley, Daniel Withers, Mihai Vioreanu, Ray Moran

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2019

Abstract

Purpose

To evaluate whether medial-sided bone bruising was associated with postero-medial meniscal tears in patients with an acute rupture of their anterior cruciate ligament (ACL).

Methods

A retrospective analysis of 150 consecutive patients who had an MRI scan within 8 weeks of their ACL rupture that underwent an ACL reconstruction was performed. Based on the intra-operative findings, two groups were identified: Group A (N = 75) had no postero-medial meniscal tear associated with the acute ACL rupture and Group B (N = 75) had a postero-medial meniscal tear found at time of reconstruction. All patients’ pre-operative MRI scans were reviewed for bone bruising in the following anatomic sites: lateral femoral condyle (LFC), lateral tibial plateau (LTP), medial femoral condyle (MFC), and medial tibial plateau (MTP).

Results

MTP bone bruising was found to be more prevalent in cases that had a postero-medial meniscal tear in the setting of an acute ACL injury (p = 0.046). MTP Grade 2 or 3 bone bruising was more common in patients that had a postero-medial meniscal tear (p = 0.046). There was a slightly higher incidence of grade 2 or 3 MTP bone bruising in cases with a postero-medial meniscal tear, although this did not reach statistical significance (n.s.) There was no difference in LFC, LTP or MFC bone bruising in patients with or without a postero-medial meniscal tear (n.s) for all.

Conclusions

Medial-sided bone bruising; especially present on the posterior tibial plateau may result from a higher injury force during the injury to the ACL. The identification of medial bone bruising on pre-operative MRI imaging following an acute ACL rupture should raise the suspicion of an associated postero-medial meniscal tear.

Level of evidence

III.

Sanders TL, Maradit Kremers H, Bryan AJ, Larson DR, Dahm DL, Levy BA, Stuart MJ, Krych AJ (2016) Incidence of anterior cruciate ligament tears and reconstruction: a 21-year population-based study. Am J Sports Med 44(6):1502–1507CrossRef

Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM (2013) A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. Am J Sports Med 41(8):1801–1807CrossRef

Keene GC, Bickerstaff D, Rae PJ, Paterson RS (1993) The natural history of meniscal tears in anterior cruciate ligament insufficiency. Am J Sports Med 21(5):672–679CrossRef

Hagino T, Ochiai S, Senga S, Yamashita T, Wako M, Ando T, Haro H (2015) Meniscal tears associated with anterior cruciate ligament injury. Arch Orthop Trauma Surg 135(12):1701–1706CrossRef

Haygood TM, Monu JU, Pope TL Jr (1994) Magnetic resonance imaging of the knee. Orthopedics 17:1067–1072PubMed

Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR (1999) Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. Radiology 211:747–753CrossRef

Brandser EA, Riley MA, Berbaum KS, el-Khoury GY, Bennett DL (1996) MR imaging of anterior cruciate ligament injury: Independent value of primary and secondary signs. AJR 167(1):121–126CrossRef

Patel SA, Hageman J, Quatman CE, Wordeman SC, Hewett TE (2014) Prevalence and location of bone bruises associated with anterior cruciate ligament injury and implications for mechanism of injury: a systematic review. Sports Med 44(2):281–293CrossRef

Speer KP, Spritzer CE, Bassett FH III, Feagin JA Jr, Garrett WE Jr (1992) Osseous injury associated with acute tears of the anterior cruciate ligament. Am J Sports Med 20(4):382–389CrossRef

10.

Viskontas DG, Giuffre BM, Duggal N, Graham D, Parker D, Coolican M (2008) Bone bruises associated with ACL rupture: correlation with injury mechanism. Am J Sports Med 36(5):927–933CrossRef

11.

Wittstein J, Vinson E, Garrett W (2014) Comparison between sexes of bone contusions and meniscal tear patterns in noncontact anterior cruciate ligament injuries. Am J Sports Med 42(6):1401–1407CrossRef

12.

Costa-Paz M, Muscolo DL, Ayerza M, Makino A, Aponte-Tinao L (2001) Magnetic resonance imaging follow-up study of bone bruises associated with anterior cruciate ligament ruptures. Arthroscopy 17(5):445–449CrossRef

13.

DePhillipo NN, Cinque ME, Chahla J, Geeslin AG, Engebretsen L, LaPrade RF (2017) Incidence and detection of meniscal ramp lesions on magnetic resonance imaging in patients with anterior cruciate ligament reconstruction. Am J Sports Med 45(10):2233–2237CrossRef

14.

Owusu-Akyaw KA, Kim SY, Spritzer CE, Collins AT, Englander ZA, Utturkar GM, Garrett WE, DeFrate LE (2018) Determination of the position of the knee at the time of an anterior cruciate ligament rupture for male versus female patients by an analysis of bone bruises. Am J Sports Med 46(7):1559–1565CrossRef

15.

Colby S, Francisco A, Yu B, Kirkendall D, Finch M, Garrett W Jr (2000) Electromyographic and kinematic analysis of cutting maneuvers.Implications for anterior cruciate ligament injury. Am J Sports Med 28(2):234–240CrossRef

16.

Graf BK, Cook DA, De Smet AA, Keene JS (1993) “Bone bruises” on magnetic resonance imaging evaluation of anterior cruciate ligament injuries. Am J Sports Med 21(2):220–223CrossRef

17.

Spindler KP, Schils JP, Bergfeld JA et al (1993) Prospective study of osseous, articular, and meniscal lesions in recent anterior cruciate ligament tears by magnetic resonance imaging and arthroscopy. Am J Sports Med 21:551–557CrossRef

18.

Rosen MA, Jackson DW, Berger PE (1991) Occult osseous lesions documented by magnetic resonance imaging associated with anterior cruciate ligament ruptures. Arthroscopy 7:45–51CrossRef

19.

Hayes CW, Brigido MK, Jamadar DA, Propeck T (2000) Mechanism-based pattern approach to classification of complex injuries of the knee depicted at MR imaging. Radiographics 20:S121–S134CrossRef

20.

Hayes CW, Coggins CA (2006) Sports-related injuries of the knee: an approach to MRI interpretation. Clin Sports Med 25:659–679CrossRef

21.

Terizidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P (2004) The appearance of kissing contusion in the acutely injured knee in the athletes. Br J Sports Med 38:592–596CrossRef

22.

Sanders TG, Medynski MA, Feller JF, Lawhorn KW (2000) Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics 20:S135–S151CrossRef

23.

Aravindh P, Wu T, Chan XC, Wong LK, Krishna L (2018) Association of compartmental bone bruise distribution with concomitant intra-articular and extra-articular injuries in acute anterior cruciate ligament tears after noncontact sports trauma. Orthop J Sports Med. https://doi.org/10.1177/2325967118767625 CrossRefPubMedPubMedCentral

Title: Posterior tibial bone bruising associated with posterior-medial meniscal tear in patients with acute anterior cruciate ligament injury
Authors: Manuel Calvo-Gurry
Eoghan T. Hurley
Daniel Withers
Mihai Vioreanu
Ray Moran
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-019-05490-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Posterior tibial bone bruising associated with posterior-medial meniscal tear in patients with acute anterior cruciate ligament injury

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Please log in to get access to this content

Other articles of this Issue 11/2019

Radiographic images are inapplicable for a precise evaluation of the femoral tunnel position following MPFL reconstruction

Tibial slope and medial meniscectomy significantly influence short-term knee laxity following ACL reconstruction

A more flattened bone tunnel has a positive effect on tendon–bone healing in the early period after ACL reconstruction

Superior knee flexor strength at 2 years with all-inside short-graft anterior cruciate ligament reconstruction vs a conventional hamstring technique

Letter to the editor

Mid-flexion laxity in the asymptomatic native knee is predominantly present on the lateral side