Ramp lesions are six times more likely to be observed in the presence of a posteromedial tibial bone bruise

2021 ◽  
Vol 37 (2) ◽  
pp. 184-185
Author(s):  
W. Beel ◽  
C. Mouton ◽  
D. Tradati ◽  
C. Nührenbörger ◽  
R. Seil
Keyword(s):  
Bone Bruise ◽  
Tibial Bone

Incidence and Detection of Meniscal Ramp Lesions on Magnetic Resonance Imaging in Patients With Anterior Cruciate Ligament Reconstruction

2017 ◽  
Vol 45 (10) ◽  
pp. 2233-2237 ◽  
Author(s):  
Nicholas N. DePhillipo ◽  
Mark E. Cinque ◽  
Jorge Chahla ◽  
Andrew G. Geeslin ◽  
Lars Engebretsen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Tibial Bone ◽  
Ramp Lesion ◽  
Anterior Cruciate

Background: Meniscal ramp lesions have been reported to be present in 9% to 17% of patients undergoing anterior cruciate ligament (ACL) reconstruction. Detection at the time of arthroscopy can be accomplished based on clinical suspicion and careful evaluation. Preoperative assessment via magnetic resonance imaging (MRI) has been reported to have a low sensitivity in identifying meniscal ramp lesions. Purpose: To investigate the incidence of meniscal ramp lesions in patients with ACL tears and the sensitivity of preoperative MRI for the detection of ramp lesions. Study Design: Case series; Level of evidence, 4. Methods: All patients who underwent ACL reconstruction by a single surgeon between 2010 and 2016 were included in this study, and patients with medial meniscal ramp lesions found at the time of arthroscopy were identified. The sensitivity of MRI compared with the gold standard of arthroscopic evaluation was determined by review of the preoperative MRI musculoskeletal radiologist report, mimicking the clinical scenario. The incidence was calculated based on arthroscopic findings, and the potential secondary signs of meniscal ramp tears were evaluated on MRI. Results: In a consecutive series of 301 ACL reconstructions, 50 patients (33 male, 17 female) with a mean age of 29.6 years (range, 14-61 years) were diagnosed with a medial meniscal ramp lesion at arthroscopic evaluation (16.6% incidence). The sensitivity of MRI for ramp lesions was 48% based on the preoperative MRI report. A secondary finding of a posteromedial tibial bone bruise was identified on preoperative MRI in 36 of the 50 patients with ramp lesions in a retrospective MRI review by 2 orthopaedic surgeons. Conclusion: Medial meniscal ramp lesions were present in approximately 17% of 301 patients undergoing ACL reconstruction, and less than one-half were diagnosed on the preoperative MRI. A posteromedial tibial bone bruise was found to be a secondary sign of a ramp lesion in 72% of patients. Increased awareness of this potentially combined injury pattern is necessary, and careful intraoperative evaluation is required to identify all meniscal ramp tears.

scholarly journals Posterior tibial slope: the fingerprint of the tibial bone

2021 ◽  
Author(s):  
Philipp W. Winkler ◽  
Brian M. Godshaw ◽  
Jon Karlsson ◽  
Alan M. J. Getgood ◽  
Volker Musahl
Keyword(s):  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Tibial Bone

Bone bruise in der MRT

2021 ◽  
Vol 21 (S1) ◽  
pp. 13-19
Author(s):  
H.-J. Böhm ◽  
L. W. Poll
Keyword(s):  
Bone Bruise

Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears

2021 ◽  
pp. 194173812110295
Author(s):  
Patrick Ward ◽  
Peter Chang ◽  
Logan Radtke ◽  
Robert H. Brophy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Functional Outcomes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Bone Bruises ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are common injuries; they are often associated with concomitant injuries to other structures in the knee, including bone bruises. While there is limited evidence that bone bruises are associated with slightly worse clinical outcomes, the implications of bone bruises for the articular cartilage and the risk of developing osteoarthritis (OA) in the knee are less clear. Recent studies suggest that the bone bruise pattern may be helpful in predicting the presence of meniscal ramp lesions. Evidence Acquisition: A literature review was performed in EMBASE using the keyword search phrase (acl OR (anterior AND cruciate AND ligament)) AND ((bone AND bruise) OR (bone AND contusion) OR (bone AND marrow AND edema) OR (bone AND marrow AND lesion) OR (subchondral AND edema)). Study Design: Clinical review. Level of Evidence: Level 4. Results: The literature search returned 93 articles of which 25 were ultimately included in this review. Most studies identified a high prevalence of bone bruises in the setting of acute ACL injury. Individual studies have found relationships between bone bruise volume and functional outcomes; however, these results were not supported by systematic review. Similarly, the literature has contradictory findings on the relationship between bone bruises and the progression of OA after ACL reconstruction. Investigations into concomitant injury found anterolateral ligament and meniscal ramp lesions to be associated with bone bruise presence on magnetic resonance imaging. Conclusion: Despite the ample literature identifying the prevalence of bone bruises in association with ACL injury, there is little evidence to correlate bone bruises to functional outcomes or progression of OA. Bone bruises may best be used as a marker for concomitant injury such as medial meniscal ramp lesions that are not always well visualized on magnetic resonance imaging. Further research is required to establish the longitudinal effects of bone bruises on ACL tear recovery. Strength of Recommendation Taxonomy: 2.

scholarly journals Unprecedented tibial bone lengthening of 33.5 cm by distraction osteogenesis for the reconstruction of a subtotal tibial bone defect. A case report and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Abdulnassir Ali ◽  
Ying Ren ◽  
Chun-Hao Zhou ◽  
Jia Fang ◽  
Cheng-He Qin
Keyword(s):  
Bone Defect ◽  
Distraction Osteogenesis ◽  
Chronic Osteomyelitis ◽  
Weight Bearing ◽  
Lower Leg ◽  
Bone Lengthening ◽  
Case Presentation ◽  
Tibial Length ◽  
Tibial Bone ◽  
The Right

Abstract Background We present a case of an immense unprecedented tibial bone lengthening of 33.5 cm. The management of chronic osteomyelitis of the right tibia with subtotal tibial bone defect, talus defect and equinus ankle deformity. We demonstrate limb reconstruction by distraction osteogenesis and correction of ankle deformity with the Ilizarov technique. Limb salvage was preferred as an alternative to amputation to restore basic limb function. Case presentation A 16-year-old male patient fell and injured his right lower leg. He attempted to treat the symptoms with traditional home remedies. During 15 months of self-treating, he developed osteomyelitis of the right tibia and had lost function in his foot. Radiology revealed immense bone defect of the right tibia, including talus bone defect and equinus deformity of the calcaneus. The patient’s right tibia was non weight-bearing, had drainage sinus just below his knee and a large scar anteriorly along the entire length of the tibia. Conclusion Upon completion of treatment, the patient was able to avoid amputation of his leg with partially restored function for weight-bearing. He carried himself without assistance after 3 years of lost function in his right leg. Tibial bone distraction osteogenesis of 33.5 cm was done after 90% of the tibial length was defected. To the best of our best knowledge, this case is one of a kind to achieve distraction of tibial bone to such length.

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