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First published on March 19, 2008, doi:10.1177/0363546508314791
This version was published on May 1, 2008
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The American Journal of Sports Medicine 36:927-933 (2008)
© 2008 American Orthopaedic Society for Sports Medicine

Bone Bruises Associated With ACL Rupture

Correlation With Injury Mechanism

Darius G. Viskontas, MD, FRCSC{dagger},*, Bruno M. Giuffre, MB, FRANZCR{ddagger}, Naven Duggal, MD, FRCSC§, David Graham, FRCSEd(TrandOrth)||, David Parker, MBBS, FRACS# and Myles Coolican, MBBS, FRACS#

From the {dagger} Department of Orthopaedic Surgery, Royal Columbian Hospital, New Westminster, British Columbia, Canada, {ddagger} Radiology Department, Royal North Shore Hospital, St. Leonards, Sydney, NSW, Australia, § Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, || Queen Elizabeth Hospital, Sheriff Hill, Gateshead, United Kingdom, and # Sydney Orthopaedics Arthritis and Sports Medicine, Chatswood, NSW, Australia

* Address correspondence to Darius G. Viskontas, MD, FRCSC, Department of Orthopaedic Surgery, Royal Columbian Hospital, 330 East Columbia St, New Westminster, BC, Canada V3L 1A1.

Background: Different patterns of bone bruising are seen on magnetic resonance imaging in acute anterior cruciate ligament ruptures. These patterns may relate to the mechanism of injury.

Hypothesis: There is a correlation between the mechanism of anterior cruciate ligament injury and bone bruise patterns on magnetic resonance imaging.

Study Design: Cohort study; Level of evidence, 2.

Methods: Data regarding the mechanism of anterior cruciate ligament rupture were collected prospectively on patients who had anterior cruciate ligament reconstructions. Inclusion criteria included a clear history of mechanism, magnetic resonance imaging within 6 weeks of injury, and no previous knee injury. Patients were divided into noncontact and contact mechanism groups. Bone bruise frequency, location, depth, and intensity were analyzed using magnetic resonance imaging and correlated with the mechanism of injury.

Results: Two hundred fifty-six patients were identified; 100 met the inclusion criteria, 86 were in the noncontact mechanism group, and 14 were in the contact mechanism group. The proportion of bone bruises in the lateral compartment in both groups was higher (P < .001) than in the medial compartment. Bone bruising was more frequent, deeper, and more intense in the noncontact group, with frequency (P = .019) and intensity (P < .001) scores reaching significance at the lateral tibial plateau. Medial compartment bone bruising was seen more frequently than previously reported, particularly in the noncontact group.

Conclusion: The noncontact mechanism appears to cause more severe bone bruising in both the medial and lateral compartments.

Key Words: ACL • knee • bone bruise • mechanism of injury • MRI






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