Prospective study of osseous, articular, and meniscal lesions in recent anterior cruciate ligament tears by magnetic resonance imaging and arthroscopy

• Published in: The American journal of sports medicine 1993-07, Vol.21 (4), p.551-557
• Main Authors: Spindler, Kurt P., Schils, Jean P., Bergfeld, John A., Andrish, Jack T., Weiker, Garron G., Anderson, Thomas E., Piraino, David W., Richmond, Bradford J., Medendorp, Sharon V.
• Format: Article
• Language: English
• Subjects: Adult; Anterior cruciate ligament; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries; Arthroscopy; Athletic Injuries - complications; Athletic Injuries - diagnosis; Biological and medical sciences; Bone Diseases - complications; Bone Diseases - diagnosis; Cartilage, Articular - injuries; Contusions - complications; Contusions - diagnosis; Diagnosis; Diseases of the osteoarticular system; Female; Humans; Injuries; Legs; Ligaments; Magnetic Resonance Imaging; Male; Medical sciences; Miscellaneous. Osteoarticular involvement in other diseases; Muscular system; Osteoarthritis; Prospective Studies; Sports injuries; Sports medicine; Tibial Meniscus Injuries
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/036354659302100412

Fifty-four patients with anterior cruciate ligament tears that were arthroscopically reconstructed within 3 months of initial injury were prospectively evaluated. Patients with grade 3 medial collateral ligament, lateral collateral ligament, or posterior cruciate ligament tears were excluded. Eighty percent of our patients had a bone bruise present on the magnetic resonance image, with 68% in the lateral femoral condyle. Two of the latter findings—an abnormal articular cartilage signal (P = 0.02) and a thin and impacted subchondral bone (P = 0.03)—had a significant relationship with injury to the overlying articular cartilage. Meniscal tears were found in 56% of the lateral menisci and 37% of the medial menisci. A significant association was present between bone bruising on the lateral femoral condyle and the lateral tibial plateau (P = 0.02). Results of our study support the concept that the common mechanism of injury to the anterior cruciate ligament involves severe anterior subluxation with im paction of the posterior tibia on the anterior femur. Determination of the significance of bone bruising, ar ticular cartilage injury, or meniscal tears will require a long-term followup that includes evaluation for arthritis, stability, and function. These 54 patients represent the first cohort evaluated in this ongoing prospective clinical study.