Guan-Yang Song1, Hui Zhang1, Qian-Qian Wang2, Jin Zhang1, Yue Li1, Hua Feng3. 1. Sports Medicine Service, Beijing Jishuitan Hospital, Xi Cheng District, Beijing, China. 2. Clinical Research and Evidence-based Medicine Center, Beijing Institute of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Xi Cheng District, Beijing, China. 3. Sports Medicine Service, Beijing Jishuitan Hospital, Xi Cheng District, Beijing, China. Electronic address: fenghua20080617@126.com.
Abstract
PURPOSE: To examine the associated findings with bone contusions in patients after acute noncontact anterior cruciate ligament (ACL) injuries. METHODS: From January 1, 2011, to December 31, 2013, patients who underwent ACL reconstructions performed by the senior author (H.F.) were retrospectively analyzed. Presence and severity of bone contusion were determined from preoperative magnetic resonance images (MRIs) for each anatomic site including the lateral femoral condyle (LFC), lateral tibial plateau (LTP), medial femoral condyle (MFC), and medial tibial plateau (MTP). Multivariable logistic regression was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associated findings (demographic data, preoperative physical examinations, concomitant meniscal lesions, intra-articular cartilage damages, and anterolateral ligament [ALL] abnormality) with bone contusions. Outcomes included the presence of bone contusions at each anatomic site (LFC, LTP, MFC, and MTP) and severity of lateral bone contusions (moderate/severe vs none/minimal). RESULTS: Among the 697 consecutive cases, 193 were finally selected. Prevalence of bone contusions seen on MRI was as follows: 60.6% LFC, 73.1% LTP, 6.2% MFC, and 21.2% MTP. Presence of bone contusions at LFC and LTP were significantly associated with high-grade (grade II and III) pivot-shift (ORLFC, 7.39; 95% CI, 1.99, 27.44; ORLTP, 2.52; 95% CI, 1.02, 6.24), concomitant lateral meniscal lesions (ORLFC, 3.23; 95% CI, 1.93, 11.31; ORLTP, 10.17; 95% CI, 1.86, 55.47), and ALL abnormality (ORLFC, 3.79; 95% CI, 1.46, 9.84; ORLTP, 4.47; 95% CI, 1.28, 15.58). However, none of the above associated findings was correlated with the presence of bone contusions at MFC and MTP. Furthermore, moderate/severe lateral bone contusions were still found to be significantly associated with high-grade (grade II and III) pivot-shift (ORLFC, 14.89; 95% CI, 2.71, 82.11; ORLTP, 6.76; 95% CI, 1.27, 36.06), concomitant lateral meniscal lesions (ORLFC, 17.34; 95% CI, 3.91, 76.87; ORLTP, 22.01; 95% CI, 5.08, 95.42), and ALL abnormality (ORLFC, 4.02; 95% CI, 1.33, 12.09; ORLTP, 2.57; 95% CI, 1.09, 6.04). CONCLUSIONS: For acute noncontact ACL injury, both the presence and the severity of lateral bone contusions are associated with high-grade (grade II and III) pivot-shift, concomitant lateral meniscal lesions, and ALL abnormality. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
PURPOSE: To examine the associated findings with bone contusions in patients after acute noncontact anterior cruciate ligament (ACL) injuries. METHODS: From January 1, 2011, to December 31, 2013, patients who underwent ACL reconstructions performed by the senior author (H.F.) were retrospectively analyzed. Presence and severity of bone contusion were determined from preoperative magnetic resonance images (MRIs) for each anatomic site including the lateral femoral condyle (LFC), lateral tibial plateau (LTP), medial femoral condyle (MFC), and medial tibial plateau (MTP). Multivariable logistic regression was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associated findings (demographic data, preoperative physical examinations, concomitant meniscal lesions, intra-articular cartilage damages, and anterolateral ligament [ALL] abnormality) with bone contusions. Outcomes included the presence of bone contusions at each anatomic site (LFC, LTP, MFC, and MTP) and severity of lateral bone contusions (moderate/severe vs none/minimal). RESULTS: Among the 697 consecutive cases, 193 were finally selected. Prevalence of bone contusions seen on MRI was as follows: 60.6% LFC, 73.1% LTP, 6.2% MFC, and 21.2% MTP. Presence of bone contusions at LFC and LTP were significantly associated with high-grade (grade II and III) pivot-shift (ORLFC, 7.39; 95% CI, 1.99, 27.44; ORLTP, 2.52; 95% CI, 1.02, 6.24), concomitant lateral meniscal lesions (ORLFC, 3.23; 95% CI, 1.93, 11.31; ORLTP, 10.17; 95% CI, 1.86, 55.47), and ALL abnormality (ORLFC, 3.79; 95% CI, 1.46, 9.84; ORLTP, 4.47; 95% CI, 1.28, 15.58). However, none of the above associated findings was correlated with the presence of bone contusions at MFC and MTP. Furthermore, moderate/severe lateral bone contusions were still found to be significantly associated with high-grade (grade II and III) pivot-shift (ORLFC, 14.89; 95% CI, 2.71, 82.11; ORLTP, 6.76; 95% CI, 1.27, 36.06), concomitant lateral meniscal lesions (ORLFC, 17.34; 95% CI, 3.91, 76.87; ORLTP, 22.01; 95% CI, 5.08, 95.42), and ALL abnormality (ORLFC, 4.02; 95% CI, 1.33, 12.09; ORLTP, 2.57; 95% CI, 1.09, 6.04). CONCLUSIONS: For acute noncontact ACL injury, both the presence and the severity of lateral bone contusions are associated with high-grade (grade II and III) pivot-shift, concomitant lateral meniscal lesions, and ALL abnormality. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Authors: Sophia Y Kim-Wang; Melissa B Scribani; Michael B Whiteside; Louis E DeFrate; Tally E Lassiter; Jocelyn R Wittstein Journal: Am J Sports Med Date: 2021-01-07 Impact factor: 6.202