Ricardo Bastos1,2,3,4,5, Renato Andrade1,2,6, Sebastiano Vasta7, Rogério Pereira1,2,6,8, Rocco Papalia7, Willem van der Merwe9, Scott Rodeo10, João Espregueira-Mendes11,12,13,14. 1. Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal. 2. Dom Henrique Research Centre, Porto, Portugal. 3. Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil. 4. 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal. 5. ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal. 6. Faculty of Sports, University of Porto, Porto, Portugal. 7. Orthopaedics and Trauma Surgery Department, University Campus Bio-Medico of Rome, Rome, Italy. 8. University Fernando Pessoa, Porto, Portugal. 9. University of Cape Town, Cape Town, South Africa. 10. Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA. 11. Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal. espregueira@dhresearchcentre.com. 12. Dom Henrique Research Centre, Porto, Portugal. espregueira@dhresearchcentre.com. 13. Orthopaedics Department, Minho University, Minho, Portugal. espregueira@dhresearchcentre.com. 14. ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal. espregueira@dhresearchcentre.com.
Abstract
PURPOSE: This study aimed at evaluating the association between the volume of the bone bruises and the magnitude of knee sagittal laxity and presence of meniscal injury in patients with anterior cruciate ligament (ACL) rupture. It was hypothesized that higher volumes of bone bruises will be associated with increased knee laxity and the presence of meniscal injury. METHODS: Patients with clinical diagnosis of ACL injury were referred for magnetic resonance imaging (MRI) and knee sagittal laxity measurement with a mechanical instrumented device (Porto-Knee Testing Device). The femoral and tibial bone bruises were assessed by MRI and the volume measured by manually contouring the bone bruise using a computerized software and computed by a mathematical algorithm combining all measured areas. The ACL rupture type (partial or total), meniscal tear (medial or lateral), and the localization of bone bruise were also analyzed. RESULTS: Seventy-six ACL-ruptured participants were included and 34 patients displayed bone bruises. Tibiofemoral sagittal laxity was higher in participants with complete ACL rupture (p < 0.05), but not influenced by the volume of bone bruises and meniscal status (n.s.). The volume of bone bruises was not significantly associated with the meniscal lesion or with the tibiofemoral sagittal laxity, independently of the meniscal injury status (n.s.). CONCLUSIONS: The volume of femoral and/or tibial bone bruises was not associated with the type of ACL injury, tibiofemoral sagittal laxity or the status of meniscal injury. Bone bruises must be considered as a radiographic sign of injury and should not be suggestive of injury severity and not overvalued. LEVEL OF EVIDENCE: Retrospective cohort study, Level III. IRB NUMBER: 0011/0014.
PURPOSE: This study aimed at evaluating the association between the volume of the bone bruises and the magnitude of knee sagittal laxity and presence of meniscal injury in patients with anterior cruciate ligament (ACL) rupture. It was hypothesized that higher volumes of bone bruises will be associated with increased knee laxity and the presence of meniscal injury. METHODS:Patients with clinical diagnosis of ACL injury were referred for magnetic resonance imaging (MRI) and knee sagittal laxity measurement with a mechanical instrumented device (Porto-Knee Testing Device). The femoral and tibial bone bruises were assessed by MRI and the volume measured by manually contouring the bone bruise using a computerized software and computed by a mathematical algorithm combining all measured areas. The ACL rupture type (partial or total), meniscal tear (medial or lateral), and the localization of bone bruise were also analyzed. RESULTS: Seventy-six ACL-ruptured participants were included and 34 patients displayed bone bruises. Tibiofemoral sagittal laxity was higher in participants with complete ACL rupture (p < 0.05), but not influenced by the volume of bone bruises and meniscal status (n.s.). The volume of bone bruises was not significantly associated with the meniscal lesion or with the tibiofemoral sagittal laxity, independently of the meniscal injury status (n.s.). CONCLUSIONS: The volume of femoral and/or tibial bone bruises was not associated with the type of ACL injury, tibiofemoral sagittal laxity or the status of meniscal injury. Bone bruises must be considered as a radiographic sign of injury and should not be suggestive of injury severity and not overvalued. LEVEL OF EVIDENCE: Retrospective cohort study, Level III. IRB NUMBER: 0011/0014.
Entities:
Keywords:
Bone bruise; Bone contusion; Knee laxity; Meniscal injury
Authors: Renato Andrade; Rogério Pereira; Ana Leal; Bruno Pereira; João Paulo Vilas Boas; C Niek van Dijk; João Espregueira-Mendes Journal: Porto Biomed J Date: 2021-02-11