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A bone bruise at the lateral and medial tibial plateau with an anterior cruciate ligament injury is associated with a meniscus tear

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Bone bruises with anterior cruciate ligament (ACL) injury are well studied, but the association between bone bruises and multiple factors is unclear. The main objective of this study was to investigate the association between bone bruising and ACL injury and concomitant injury as well as clinical and functional scores. The second objective was to investigate the presence and distribution patterns of bone bruises.

Method

A total of 176 patients who underwent ACL reconstruction for primary ACL injury were included. The demographic characteristics and responses to clinical and functional assessments (the Visual Analog Scale for activities of daily living and sports, the Cincinnati Knee Rating System, the Lysholm score, the Knee Osteoarthritis Outcome Score and side-to-side difference in anterior laxity) were recorded at the initial visit. Concomitant injuries were evaluated by intraoperative assessment.

Results

Bone bruises were detected in 141 patients (80.1%). The lateral femoral condyle (LFC) was the most common site in 116 patients (65.9%), followed by the lateral tibial plateau (LTP) in 82 patients (46.6%), medial tibial plateau (MTP) in 47 patients (26.7%) and medial femoral condyle (MFC) in 29 patients (16.5%). Regarding the distribution patterns, bone bruising at only the LFC, which was the most common pattern, was detected in 38 patients (27.0%). Bone bruising at the LTP or MTP was significantly associated with lateral (LM) and medial meniscus (MM) tears (odds ratios 4.0, 3.0, 4.3 and 40.5, 95% confidence intervals 1.5–11.6, 1.2–15.1, 1.2–17.3 and 8.6–283.0, respectively). No marked differences in the functional or clinical scores were noted. The severity of bone bruising at the MTP was significantly associated with MM tears and that at the LTP was significantly associated with LM tears. (p < 0.01).

Conclusion

This study showed association between bone bruising at LTP and LM tears or at MTP and MM tears. Additionally, it provided detailed information on the presence and distribution patterns of bone bruises at each anatomic site. These findings are clinically relevant and will aid in preoperatively diagnosing meniscus tears in cases of ACL injury.

Level of evidence

Level III.

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Acknowledgements

The authors would like to thank Junichiro Yamaguchi (Department of Orthopaedic Surgery, Koshigaya Municipal Hospital) for their useful discussion with respect to the writing of the manuscript.

Funding

There are no findings for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Koshigaya Municipal Hospital, 10-3 Higashi koshigaya, Koshigaya-shi, Saitama, 343-8577, Japan

    Youngji Kim, Mitsuaki Kubota, Taisuke Sato, Tetsuya Inui & Ryuichi Ohno

  2. Department of Orthopaedics, Juntendo University, Faculty of Medicine, 3-1-3 Hongo, Bunkyoku, Tokyo, 113-8431, Japan

    Youngji Kim, Mitsuaki Kubota, Taisuke Sato, Tetsuya Inui, Ryuichi Ohno & Muneaki Ishijima

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  1. Youngji Kim
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Correspondence to Mitsuaki Kubota.

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The authors have no conflicts of interest directly relevant to the content of this article.

Ethical approval

This retrospective study was approved by our institution ethics committee (IRB No. 2019–11).

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Standard informed consent was obtained from all patients participating in this study.

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Kim, Y., Kubota, M., Sato, T. et al. A bone bruise at the lateral and medial tibial plateau with an anterior cruciate ligament injury is associated with a meniscus tear. Knee Surg Sports Traumatol Arthrosc 30, 2298–2306 (2022). https://doi.org/10.1007/s00167-021-06786-3

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