Imaging of Noncontact Anterior Cruciate Ligament Injuries and Associated Bone Marrow Contusion Patterns

Cruciate Ligament ◽

Axial Loading ◽

Lateral Compartment ◽

Medial Compartment ◽

Concomitant Injuries ◽

Increased Risk ◽

Anterior Cruciate ◽

Bone Contusions

AbstractAnterior cruciate ligament (ACL) tears are commonly associated with bone contusions. Bone contusions can lend important insight into increased risk for more subtle concurrent injuries based on common injury mechanisms and patterns, as higher energy trauma has been tied to patterns of specific bone contusions and concomitant injuries. Lateral compartment contusions are most common and occur in pivot shift injuries. Medial compartment contusions may represent a contrecoup mechanism after the initial lateral injuries. Patellotibial contusions require axial loading but are also typically seen in conjunction with lateral and medial compartment contusions. The differences in ACL injury mechanics and physiology as shown by imaging contusion patterns can help clinicians better identify and treat the concurrent associated injuries.

Predictors of Radiographic Osteoarthritis 2 to 3 Years After Anterior Cruciate Ligament Reconstruction: Data From the MOON On-site Nested Cohort

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119867085 ◽

2019 ◽

Vol 7 (8) ◽

pp. 232596711986708 ◽

Cited By ~ 1

Author(s):

◽

Morgan H. Jones ◽

Sameer R. Oak ◽

Jack T. Andrish ◽

Robert H. Brophy ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Cruciate Ligament ◽

Meniscal Repair ◽

Medial Compartment ◽

Acl Tear ◽

Increased Risk ◽

Anterior Cruciate ◽

And Cartilage

Background: Multiple studies have shown that patients are susceptible to posttraumatic osteoarthritis (PTOA) after an anterior cruciate ligament (ACL) injury, even with ACL reconstruction (ACLR). Prospective studies using multivariable analysis to identify risk factors for PTOA are lacking. Purpose/Hypothesis: This study aimed to identify baseline predictors of radiographic PTOA after ACLR at an early time point. We hypothesized that meniscal injuries and cartilage lesions would be associated with worse radiographic PTOA using the Osteoarthritis Research Society International (OARSI) atlas criteria. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 421 patients who underwent ACLR returned on-site for standardized posteroanterior semiflexed knee radiography at a minimum of 2 years after surgery. The mean age was 19.8 years, with 51.3% female patients. At baseline, data on demographics, graft type, meniscal status/treatment, and cartilage status were collected. OARSI atlas criteria were used to grade all knee radiographs. Multivariable ordinal regression models identified baseline predictors of radiographic OARSI grades at follow-up. Results: Older age (odds ratio [OR], 1.06) and higher body mass index (OR, 1.05) were statistically significantly associated with a higher OARSI grade in the medial compartment. Patients who underwent meniscal repair and partial meniscectomy had statistically significantly higher OARSI grades in the medial compartment (meniscal repair OR, 1.92; meniscectomy OR, 2.11) and in the lateral compartment (meniscal repair OR, 1.96; meniscectomy OR, 2.97). Graft type, cartilage lesions, sex, and Marx activity rating scale score had no significant association with the OARSI grade. Conclusion: Older patients with a higher body mass index who have an ACL tear with a concurrent meniscal tear requiring partial meniscectomy or meniscal repair should be advised of their increased risk of developing radiographic PTOA. Alternatively, patients with an ACL tear with an articular cartilage lesion can be reassured that they are not at an increased risk of developing early radiographic knee PTOA at 2 to 3 years after ACLR.

Does the Curved Nature of the Tibia Influence the Non-Contact ACL Injury?

Volume 2: Biomedical and Biotechnology ◽

10.1115/imece2012-89422 ◽

2012 ◽

Author(s):

Ariful I. Bhuiyan ◽

Javad Hashemi ◽

James R. Slauterbeck

Keyword(s):

Cruciate Ligament ◽

Acl Injury ◽

Magnetic Resonance Images ◽

Medial Compartment ◽

Ligament Injury ◽

Increased Risk ◽

Anterior Cruciate ◽

Matlab Programming

The geometry of the tibial plateau and the femoral condyles are emerging as key parameters to be studied as anterior cruciate ligament (ACL) injury risk factors. In this paper, we study the role of curved profile of the medial compartment of the tibia in a sagittal plane as a critical risk factor for the anterior cruciate ligament (ACL) injuries. The curvature of the mid-medial compartment of Tibia in 40 uninjured controls (21 women and 19 men) and 44 anterior cruciate ligament-injured cases (23 women and 21 men) were measured using magnetic resonance images and in-house matlab programming. We hypothesized that the Individuals with a less curved profile in the medial compartment of the tibia are at increased risk of suffering an anterior cruciate ligament injury compared to those with larger curved profiles. Based on t-tests, we established that the uninjured controls had larger curvature (p<0.05) compared to the injured cases. Biomechanically speaking a larger curvature of the tibia could prevent excessive sliding movement of femur with respect to the tibia, and thus could reduce the ACL strain. We suggest that future studies are needed to confirm this relationship and to evaluate the potential role of this curved profile of tibia in the risk of ACL injury.

Influence of Menstrual Cycle on Anterior Cruciate Ligament Injuries in the Knee: A Systematic Review of the Literature

Slovenian Journal of Public Health ◽

10.2478/sjph-2014-0025 ◽

2014 ◽

Vol 53 (3) ◽

pp. 270-274

Author(s):

Anton Tomšič ◽

Marjan Bilban ◽

Matej Drobnič

Keyword(s):

Menstrual Cycle ◽

Preventive Measures ◽

Cruciate Ligament ◽

Serum Levels ◽

Ligament Injuries ◽

Female Population ◽

Increased Risk ◽

Anterior Cruciate

Abstract Anterior cruciate ligament injuries of the knee represent an increasing problem among the active female population in comparison to their male counterparts. Besides temporary or prolonged joint dysfunction, such injuries may predispose an individual to early osteo-arthritis. Recognizing the sex differences is essential for the determination of preventive measures against these injuries. Besides anatomical and biomechanical differences, the role of hormonal oscillation during the menstrual cycle has been hypothesized. This manuscript presents a literature review based on cruciate ligament and menstrual cycle research published between 1992 and 2012. According to the experimental and epidemiologic studies, menstrual cycle was shown to be linked to anterior cruciate ligament injuries. The pre-ovulatory phase represents an increased risk, with the peak serum levels of estrogen emerging toward the end of that phase. However, the significance of menstrual cycle seems to be of lesser importance in preventive measures against female anterior cruciate injuries.

Comparison Between Sexes of Bone Contusions and Meniscal Tear Patterns in Noncontact Anterior Cruciate Ligament Injuries

The American Journal of Sports Medicine ◽

10.1177/0363546514527415 ◽

2014 ◽

Vol 42 (6) ◽

pp. 1401-1407 ◽

Cited By ~ 20

Author(s):

Jocelyn Wittstein ◽

Emily Vinson ◽

William Garrett

Keyword(s):

Cruciate Ligament ◽

Meniscal Tear ◽

Ligament Injuries ◽

Anterior Cruciate ◽

Bone Contusions

The Incidence of Anterior Cruciate Ligament Injuries among Competitive Alpine Skiers

The American Journal of Sports Medicine ◽

10.1177/0363546507301083 ◽

2007 ◽

Vol 35 (7) ◽

pp. 1070-1074 ◽

Cited By ~ 94

Author(s):

Nicolas Pujol ◽

Marie Philippe Rousseaux Blanchi ◽

Pierre Chambat

Keyword(s):

Anterior Cruciate Ligament Injury ◽

Cruciate Ligament ◽

Injury Rate ◽

Ligament Injury ◽

Ligament Injuries ◽

Injury Rates ◽

Alpine Skiers ◽

Anterior Cruciate

Background Little is known about the evolution of anterior cruciate ligament injury rates among elite alpine skiers. Purpose To evaluate epidemiologic aspects of anterior cruciate ligament injuries among competitive alpine skiers during the last 25 years. Study Design Descriptive epidemiology study. Methods Data were collected from elite French national teams (379 athletes: 188 women and 191 men) from 1980 to 2005. Results Fifty-three of the female skiers (28.2%) and 52 of the male skiers (27.2%) sustained at least 1 anterior cruciate ligament injury. The overall anterior cruciate ligament injury incidence was 8.5 per 100 skier-seasons. The primary anterior cruciate ligament injury rate was 5.7 per 100 skier-seasons. The prevalence of reinjury (same knee) was 19%. The prevalence of a bilateral injury (injury of the other knee) was 30.5%. At least 1 additional anterior cruciate ligament surgery (mean, 2.4 procedures) was required for 39% of the injured athletes. Men and women were similar with regard to primary anterior cruciate ligament injury rate (P = .21), career remaining after the injury (P = .44), and skiing specialty (P = .5). There were more anterior cruciate ligament injuries (primary, bilateral, reinjuries) among athletes ranking in the world Top 30 (P < .001). Anterior cruciate ligament-injured athletes had a career length of 7.5 years, whereas athletes with no anterior cruciate ligament injury had a career of 4.5 years (P < .001). Finally, injury rates remained constant over time. Conclusion Anterior cruciate ligament injury rates (primary injury, bilateral injury, reinjury) among national competitive alpine skiers are high and have not declined in the last 25 years. Finding a way to prevent anterior cruciate ligament injury in this population is a very important goal.