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Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence

BACKGROUND: Bone bruises are frequently associated with anterior cruciate ligament (ACL) tears as a result of trauma or direct shear stress of the bone. PURPOSE: To review the evidence regarding the characteristics of the bone bruise associated with ACL tears, its relevance on clinical outcomes, and...

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Autores principales: Papalia, Rocco, Torre, Guglielmo, Vasta, Sebastiano, Zampogna, Biagio, Pedersen, Douglas R, Denaro, Vincenzo, Amendola, Annunziato
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340462/
https://www.ncbi.nlm.nih.gov/pubmed/25733936
http://dx.doi.org/10.2147/OAJSM.S75345
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author Papalia, Rocco
Torre, Guglielmo
Vasta, Sebastiano
Zampogna, Biagio
Pedersen, Douglas R
Denaro, Vincenzo
Amendola, Annunziato
author_facet Papalia, Rocco
Torre, Guglielmo
Vasta, Sebastiano
Zampogna, Biagio
Pedersen, Douglas R
Denaro, Vincenzo
Amendola, Annunziato
author_sort Papalia, Rocco
collection PubMed
description BACKGROUND: Bone bruises are frequently associated with anterior cruciate ligament (ACL) tears as a result of trauma or direct shear stress of the bone. PURPOSE: To review the evidence regarding the characteristics of the bone bruise associated with ACL tears, its relevance on clinical outcomes, and its progression over time. In particular, the long-term effects of the bone bruise on the knee osteochondral architecture and joint function were evaluated. STUDY DESIGN: Review; level of evidence: 4. METHODS: An electronic search was performed on PubMed. Combinations of keywords included: “bone bruise AND knee”; “bone bruise AND anterior cruciate ligament”; “bone bruise AND osteo-chondral defects”. Any level of evidence studies concerning bone bruises in patients with partial or complete ACL tears were retrieved. RESULTS: A total of 25 studies were included; three of them investigated biomechanical parameters, seven were concerned with clinical outcomes, and 15 were radiological studies. Evaluation of the bone bruise is best performed using a fat-saturated T2-weighted fast spin echo exam or a short tau inversion recovery sequence where fat saturation is challenging. The location of the injury has been demonstrated to be more frequent in the lateral compartment of the joint (lateral femoral condyle and lateral tibial plateau). It is associated with ACL tears in approximately 70% of cases, often with collateral ligament or meniscal tears. Mid- and long-term outcomes demonstrated a complete healing of the marrow lesions at magnetic resonance imaging, but chondral defects detected with T1ρ sequences are still present 1 year after the ACL injury. Functional examination of the knee, through clinical International Knee Documentation Committee scores, did not show any correlation with the bone bruise. CONCLUSION: Although bone bruise presence yields to higher pain levels, no correlation with functional outcomes was reported. Most studies have a short-term follow-up (<2 years) compared to the length of time it takes to develop post-traumatic osteoarthritis, so it still remains unclear whether the initial joint injury and bone bruise have a direct relationship to long-term function.
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spelling pubmed-43404622015-03-02 Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence Papalia, Rocco Torre, Guglielmo Vasta, Sebastiano Zampogna, Biagio Pedersen, Douglas R Denaro, Vincenzo Amendola, Annunziato Open Access J Sports Med Review BACKGROUND: Bone bruises are frequently associated with anterior cruciate ligament (ACL) tears as a result of trauma or direct shear stress of the bone. PURPOSE: To review the evidence regarding the characteristics of the bone bruise associated with ACL tears, its relevance on clinical outcomes, and its progression over time. In particular, the long-term effects of the bone bruise on the knee osteochondral architecture and joint function were evaluated. STUDY DESIGN: Review; level of evidence: 4. METHODS: An electronic search was performed on PubMed. Combinations of keywords included: “bone bruise AND knee”; “bone bruise AND anterior cruciate ligament”; “bone bruise AND osteo-chondral defects”. Any level of evidence studies concerning bone bruises in patients with partial or complete ACL tears were retrieved. RESULTS: A total of 25 studies were included; three of them investigated biomechanical parameters, seven were concerned with clinical outcomes, and 15 were radiological studies. Evaluation of the bone bruise is best performed using a fat-saturated T2-weighted fast spin echo exam or a short tau inversion recovery sequence where fat saturation is challenging. The location of the injury has been demonstrated to be more frequent in the lateral compartment of the joint (lateral femoral condyle and lateral tibial plateau). It is associated with ACL tears in approximately 70% of cases, often with collateral ligament or meniscal tears. Mid- and long-term outcomes demonstrated a complete healing of the marrow lesions at magnetic resonance imaging, but chondral defects detected with T1ρ sequences are still present 1 year after the ACL injury. Functional examination of the knee, through clinical International Knee Documentation Committee scores, did not show any correlation with the bone bruise. CONCLUSION: Although bone bruise presence yields to higher pain levels, no correlation with functional outcomes was reported. Most studies have a short-term follow-up (<2 years) compared to the length of time it takes to develop post-traumatic osteoarthritis, so it still remains unclear whether the initial joint injury and bone bruise have a direct relationship to long-term function. Dove Medical Press 2015-02-18 /pmc/articles/PMC4340462/ /pubmed/25733936 http://dx.doi.org/10.2147/OAJSM.S75345 Text en © 2015 Papalia et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Papalia, Rocco
Torre, Guglielmo
Vasta, Sebastiano
Zampogna, Biagio
Pedersen, Douglas R
Denaro, Vincenzo
Amendola, Annunziato
Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence
title Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence
title_full Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence
title_fullStr Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence
title_full_unstemmed Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence
title_short Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence
title_sort bone bruises in anterior cruciate ligament injured knee and long-term outcomes. a review of the evidence
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340462/
https://www.ncbi.nlm.nih.gov/pubmed/25733936
http://dx.doi.org/10.2147/OAJSM.S75345
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