Abstract
Purpose: The purpose of this study was to perform a magnetic resonance imaging (MRI) follow-up
study of bone bruises in a group of patients with acute anterior cruciate ligament
(ACL) ruptures that were reconstructed and followed-up for a minimum of 2 years. Type of Study: Cohort study. Methods: The study group included 21 patients with a mean age of 31 years whose initial MRI
scans showed associated bone bruises. Patients were included if they had an acute
isolated ACL tear, no documentation of an episode of repeated injury to the affected
knee during the follow-up period, and no evidence of cartilaginous injury at the time
of arthroscopy. All patients had preoperative MRI scans and underwent arthroscopic
ACL reconstruction using a bone–patellar tendon autograft an average of 2 months after
injury. The preoperative MRI scans were analyzed using a 3-level grading system based
on the appearance and location of bone bruises. A second MRI of the knee was obtained
from 24 to 64 months postoperatively (average 34 months). The presence of resolution
of bone bruises was determined and correlation with clinical scoring established.
Results: This study showed resolution of all type I lesions and 91% of type II lesions (10
of 11). In all type III lesions, an articular cartilage thinning and depression was
observed after 2 years of follow-up. In 15 patients (71%), MRI showed that the bone
bruises had resolved without apparent sequelae. In the remaining 6 patients (29%),
sequelae of the osteochondral lesion were evident on MRI. Conclusions: According to our clinical data, there was no correlation between scores obtained
from patients with resolved lesions against those with osteochondral sequelae. Although
long-term clinical implications of these findings are uncertain, a severe occult osteochondral
lesion sustained at the time of ACL rupture seems to be persistent on MRI even after
a successful reconstruction.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 5 (May-June),
2001: pp 445–449
Keywords
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Article info
Footnotes
*Address correspondence and reprint requests to Matías Costa-Paz, M.D., Carlos E. Ottolenghi Institute of Orthopedics, Hospital Italiano, Potosí 4215, (1199) Buenos Aires, Argentina. E-mail: [email protected]
Identification
Copyright
© 2001 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
