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Abstract
The treatment of ligament injuries of the knee has undergone rapid progress, especially
with the improvement of arthroscopic reconstruction of the anterior cruciate ligament
(ACL). Since the advent of magnetic resonance imaging (MRI) after knee trauma with
ligament injuries, interest has focussed on the clinical significance of concomitant
articular and osseous lesions. In 48 of 141 MRIs, different types of these lesions
were found; in 38 cases an arthroscopy was performed and 34 times the patients could
clinically and radiologically be examined after at least 6 months. Bone bruise was
found 26 times, in 16 cases associated with ACL-tears. Eleven patients had subchondral
fractures, 7 osteochondral fractures, and in 4 patients, stress fractures were found.
They were attributed to various mechanisms of trauma, in different percentages associated
with ligament tears and in different dimensions visible or progressive on follow-up
MRIs. Obviously some of the different lesions of subchondral and spongeous bone can
indicate later degenerative arthritis, so that we find hints for a modification of
rehabilitation, e.g., open versus closed kinetic chain or orthosis with relief of
single compartments.
Arthroscopy 1998 Sep;14(6):597-604
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Copyright
© 1998 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
