The effects of the location of acute anterior cruciate ligament rupture on areas of bone bruises
10.3760/cma.j.cn121113-20200810-00492
- VernacularTitle:急性前十字韧带撕裂位置对骨挫伤面积的影响
- Author:
Ming LI
;
Ning LIU
- From:
Chinese Journal of Orthopaedics
2021;41(2):103-108
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between the location of anterior cruciate ligament rupture (ACL) and the areas of bone bruises in patients with an acute ACL injury.Methods:A retrospective study was conducted on MRI of patients with ACL injuries from January to June 2019. According to the location of the ACL rupture on the distal to proximal length, the patients were divided into 5 groups, namely Type I, >90%; Type II, 75%-90%; Type III, 25%-75%; Type IV, 10%-25%, Type V, <10%. Gender, weight, body mass index, depth of lateral femoral condyle notch, and medial meniscus injury were compared among the five groups. The sagittal plane images of ePDWSPIRCLEAR sequence were selected to define the layer with the largest contusion areas of femur and tibia respectively. The maximum bone contusion areas of these two layers was measured using Image J 1.52t software.Results:Among the 63 cases of acute ACL injury, three cases (4.8%) were with type I tear, 14 cases (22.2%) with type II tear, 40 cases (63.5%) with type III tear, 2 cases (3.2%) with type IV tear, and 4 cases (6.3%) with Type V tear. There was no contusion of lateral femoral condyle or lateral tibial plateau bone in type I and type IV. The lateral femoral condyle bone contusion areas was 0 (0, 64.12) mm 2 in type II, 182.34 (86.58, 334.38) mm 2 in Type III, 38.64(0, 193.36) mm 2 in Type V with statistically significant difference ( H=21.665, P=0.000). The largest areas of bone contusion in the lateral tibial plateau was 76.78(28.25, 205.57) mm 2 in type II, 120.93(51.78, 239.37) mm 2 in Type III, 190.51(80.86, 238.75) mm 2 in Type V with statistically significant difference ( H=11.939, P=0.018). The maximum bone contused areas of the lateral tibial plateau in the medial meniscus injury group was 48.0(0, 105.97) mm 2, which was smaller than that in the non-injury group 185.67(54.36, 257.41) mm 2 ( H=8.848, P=0.003). The maximum bone contusion areas of the lateral femoral condyle in the injured group was 162.19(63.03, 301.33) mm 2, which was greater than 0(0, 103.37) mm 2 in the uninjured group ( H=11.554, P=0.001). Conclusion:ACL rupture often occurs in the middle segment. The middle segment ACL fracture combined with lateral meniscus injury had with the highest probability and with the largest area of bone contusion of lateral femoral condyle. The fracture of the ACL at the farthest terminal has the largest bone contusion areas of the lateral tibial plateau and with the lowest probability of combined injury of the medial meniscus.
