A. Radiologic Perspective: Patterns of Bone Marrow Edema Based on Mechanism of Injury
B. Orthopedic Perspective: Bone Injuries in Sports Medicine
  • Sailaja Yadavalli
  • Donald Resnick
  • Catherine Robertson
  • Ryan Serrano
  • Robert A. Pedowitz

Today magnetic resonance imaging (MRI) of the knee is widely used after an acute traumatic event to assess for soft tissue injuries and occult fractures.1–4 Complex injuries of the knee are rarely due to complete disruption of a single ligament without either microscopic or macroscopic changes in one or more of the supporting structures. Bone marrow edema is also frequently encountered with these injuries. The pattern of ligamentous disruption and bone marrow edema depends on the type and direction of force causing the injury.5–7 This chapter discusses the various patterns of bone contusion and correlates each to a specific mechanism of injury. A thorough understanding of this relationship is important, as it is a valuable predictor of associated soft tissue injuries.


Anterior Cruciate Ligament Stress Fracture Posterior Cruciate Ligament Tibial Plateau Medial Collateral Ligament 
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  1. 1.
    Yao L, Lee JK. Occult intraosseous fractures: detection with MR imaging. Radiology 1988;167:835–838.Google Scholar
  2. 2.
    Mink JH, Deutsch AL. Occult cartilage and bone injuries of the knee: detection, classification and assessment with MR imaging. Radiology 1989;170:823–829.PubMedGoogle Scholar
  3. 3.
    Kapelov SR, Teresi LM, Bradley WG, et al. Bone contusion of the knee: increased lesion detection with fast spin-echo MR imaging with spectroscopic fat saturation. Radiology 1993;189:901–904.PubMedGoogle Scholar
  4. 4.
    Berger PE, Ofstein RA, Jackson DW, et al. MRI demonstration of radiographically occult fractures: what have we been missing? Radiographics 1989;9(3):407–436.PubMedGoogle Scholar
  5. 5.
    Lynch TCP, Crues J V, Morgan FW, et al. Bone abnormalities of the knee: prevalence and significance at MR imaging. Radiology 1989;171:761–766.PubMedGoogle Scholar
  6. 6.
    Hayes CW, Brigido M, Jamadar DA, Propeck T. Mechanism-based pattern approach to classification of complex injuries of the knee depicted at MR imaging. Radiographics 2000;20:S121– S134.PubMedGoogle Scholar
  7. 7.
    Sanders TG, Medynski MA, Feller JF et al. Bone contusion patterns of knee at MR imaging: footprint of the mechanism of injury. Radiographics 2000;20:S135–S151.PubMedGoogle Scholar
  8. 8.
    Hayes CW, Conway WF. Normal anatomy and magnetic resonance appearance of the knee. Top Magn Reson Imaging 1993;5:207–227.PubMedCrossRefGoogle Scholar
  9. 9.
    Palmer WE, Levine SM, Dupuy DE. Knee and shoulder fractures: association of fracture detection and marrow edema on MR images with mechanism of injury. Radiology 1997;204:395–401.PubMedGoogle Scholar
  10. 10.
    Derscheid GL, Garrick JG. Medial collateral ligament injuries in football: non-operative management of grade I and grade II sprains. Am J Sports Med 1981;9:365–368.PubMedCrossRefGoogle Scholar
  11. 11.
    Fetto JF, Marshall JL. Medial collateral ligament injuries of the knee: a rationale for treatment. Clin Orthop 1978;132:206–218.PubMedGoogle Scholar
  12. 12.
    Holden DL, Eggert AW, Butler JE. The non-operative treatment of grade I and II medial collateral ligament injuries to the knee. Am J Sports Med 1983;11:340–344.PubMedCrossRefGoogle Scholar
  13. 13.
    Ellsasser JC, Reynolds FC, Omohundro JR. The non-operative treatment of collateral ligament injuries of the knee in professional football players: an analysis of seventy-four injuries treated non-operatively and twenty-four injuries treated surgically. J Bone Joint Surg Am 1974;56:1185–1190.PubMedGoogle Scholar
  14. 14.
    Schweitzer ME, Tran D, Deely DM, Hume EL. Medial collateral ligament injuries: evaluation of multiple signs, prevalence and location of associated bone bruises, and assessment with MR imaging. Radiology 1995;194:825–829.PubMedGoogle Scholar
  15. 15.
    Gravin GJ, Munk PL, Vellet AD. Tears of the medial collateral ligament: magnetic resonance imaging findings and associated injuries. Can Assoc Radiol J 1993;44:199–204.Google Scholar
  16. 16.
    Sonin AH, Fitzgerald SW, Hoff FL, et al. MR imaging of the posterior cruciate ligament: normal, abnormal and associated injury patterns. Radiographics 1995;15:551–561.PubMedGoogle Scholar
  17. 17.
    Sonin AH, Fitzgerald SW, Friedman H, et al. Posterior cruciate ligament injury: MR imaging diagnosis and patterns of injury. Radiology 1994;190:455–458.PubMedGoogle Scholar
  18. 18.
    Hoover NW. Injuries of the popliteal artery associated with fractures and dislocations. Surg Clin North Am 1961;41:1099–1112.PubMedGoogle Scholar
  19. 19.
    Miller TT, Gladden P. Straron RB, Henry JH, Feldman F. Pos-terolateral stabilizers of the knee: anatomy and injuries assessed with MR imaging. AJR Am J Roentgenol 1997;169:1641–1647.PubMedGoogle Scholar
  20. 20.
    Yu JS, Goodwing D, Salonen D, et al. Complete dislocation of the knee: spectrum of associated soft-tissue injuries depicted by MR imaging. AJR Am J Roentgenol 1995;164:135–139.PubMedGoogle Scholar
  21. 21.
    Twaddle BC, Hunter JC, Chapman JR, et al. MRI in acute knee dislocation: a prospective study of clinical, MRI and surgical findings. J Bone Joint Surg Br 1996;78:573–579.PubMedGoogle Scholar
  22. 22.
    Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part I. The medial compartment and cruciate ligaments. J Bone Joint Surg Am 1976;58(2):159–172.PubMedGoogle Scholar
  23. 23.
    Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Joint Surg Am 1976;58(2):173–179.PubMedGoogle Scholar
  24. 24.
    Rosen MA, Jackson DW, Berger PE. Occult osseous lesions documented by magnetic resonance imaging associated with anterior cruciate ligament ruptures. Arthroscopy 1991;7:45–51.PubMedGoogle Scholar
  25. 25.
    Kaplan PA, Walker CW, Kilcoyne RF, et al. Occult fracture patterns of the knee associated with anterior cruciate ligament tears: assessment with MR imaging. Radiology 1992;183:835–838.PubMedGoogle Scholar
  26. 26.
    Murphy BJ, Smith RL, Uribe JW, et al. Bone signal abnormalities in the posterolateral tibia and lateral femoral condyle in complete tears of the anterior cruciate ligament: a specific sign? Radiology 1992;182:221–224.PubMedGoogle Scholar
  27. 27.
    Remer EM, Fitzgerald SW, Friedman H, et al. Anterior cruciate ligament injury: MR imaging diagnosis and patterns of injury. Radiographics 1992;12:901–915.PubMedGoogle Scholar
  28. 28.
    Cobby MJ, Schweitzer ME, Resnick D. The deep lateral femoral notch: an indirect sign of a torn anterior cruciate ligament. Radiology 1992;184:855–858.PubMedGoogle Scholar
  29. 29.
    Graf BK, Cook DA, De Smet AA, Keene JS. “Bone bruises” on magnetic resonance imaging evaluation of anterior cruciate ligament injuries. Am J Sports Med 1993;21:220–223.PubMedCrossRefGoogle Scholar
  30. 30.
    Tung GA, Davis LM, Wiggins ME, et al. Tears of the anterior cruciate ligament: primary and secondary signs at MR imaging. Radiology 1993;188:661–667.PubMedGoogle Scholar
  31. 31.
    Robertson PL, Schweitzer ME, Bartolozzi AR, Ugoni A. Anterior cruciate ligament tears: evaluation of multiple signs with MR imaging. Radiology 1994;193:829–834.PubMedGoogle Scholar
  32. 32.
    Gentili A, Seeger LL, Yao L, Do HM. Anterior cruciate ligament tear: indirect signs at MR imaging. Radiology 1994;193:835–840.PubMedGoogle Scholar
  33. 33.
    Chan KK, Resnick D, Goodwin, Seeger LL. Posteromedial tibial plateau injury including avulsion fracture of the semimembrano-sus tendon insertion site: ancillary sign of anterior cruciate ligament tear at MR imaging. Radiology 1999;211:754–758.PubMedGoogle Scholar
  34. 34.
    Yao L, Lee JK. Avulsion of the posteromedial tibial plateau by the semimembranosus tendon: diagnosis with MR imaging. Radiology 1999;172:513–514.Google Scholar
  35. 35.
    Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR. Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangement of the knee at MR imaging. Radiology 1999;211:747–753.PubMedGoogle Scholar
  36. 36.
    Shelbourne KD, Nitz PA. The O'Donoghue triad revisited. Combined knee injuries involving anterior cruciate and medial collateral ligament tears. Am J Sports Med 1991;19(5): 474–477.PubMedCrossRefGoogle Scholar
  37. 37.
    Dietz GW, Wilcox DM, Montgomery JB. Segond tibial con-dyle fracture: lateral capsular ligament avulsion. Radiology 1986;159:467–469.PubMedGoogle Scholar
  38. 38.
    Weber WN, Neumann CH, Braakos JA, et al. Lateral tibial rim (Segond) fractures: MR imaging characteristics. Radiology 1991;180:731–734.PubMedGoogle Scholar
  39. 39.
    Stallenberg B, Genevois PA, Sintzoff SA Jr, et al. Fracture of the posterior aspect of the lateral tibial plateau: radio-graphic sign of anterior cruciate ligament tear. Radiology 1993;187:821–825.PubMedGoogle Scholar
  40. 40.
    Kirsch MD, Fitzgerald SW, Friedman H, Rogers LF. Transient lateral patellar dislocation: diagnosis with MR imaging. AJR Am J Roentgenol 1993;161:109–113.PubMedGoogle Scholar
  41. 41.
    Rorabeck CH, Bobechko WP. Acute dislocation of the patella with osteochondral fracture: a review of eighteen cases. J Bone Joint Surg Br 1976;58:237–240.PubMedGoogle Scholar
  42. 42.
    Sanders TG, Paruchuri NB, Zlatkin MB. MRI of osteochondral defects of the lateral femoral condyle: incidence and pattern of injury after transient lateral dislocation of the patella. AJR Am J Roentgenol 2006;187(5):1332–1337.PubMedCrossRefGoogle Scholar
  43. 43.
    Starok M, Lenchikl L, Trudell D, Resnick D. Normal patellar retinaculum: MR and sonographic imaging with cadaveric correlation. AJR Am J Roentgenol 1997;168:1493–1499.PubMedGoogle Scholar
  44. 44.
    Sallay PI, Poggi J, Speer K P, Garrett WE. Acute dislocation of the patella: a correlative pathoanatomic study. Am J Sports Med 1996;24:52–60.PubMedCrossRefGoogle Scholar
  45. 45.
    Feller JA, Feagin JA Jr, Garrett WE. The medial patello-femoral ligament revisited: an anatomical study. Arthroscopy 1993;1:184–186.Google Scholar
  46. 46.
    Conlan T, Grath WP Jr, Lemons JE. Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am 1993;75682–693.Google Scholar
  47. 47.
    Hautamaa PV, Fithian DC, Kaufmann KR, et al. Medial soft tissue restraints in lateral patellar instability and repair. Clin Orthop 1998;349:174–182.PubMedCrossRefGoogle Scholar
  48. 48.
    Spritzer CE, Courneya DL, Burk DL Jr, et al. Medial retinacular complex injury in acute patellar dislocation. AJR Am J Roent-genol 1997;168:117–112.Google Scholar
  49. 49.
    Hunter SC, Marascalco R, Hughston JC. Disruption of the vas-tus medialis obliquus with medial knee ligament injuries. Am J Sports Med 1983;11:427–431.PubMedCrossRefGoogle Scholar
  50. 50.
    Zanetti M, Pfirrman CW, Schmid MR, et al. Patients with suspected meniscal tears: prevalence of abnormalities seen on MRI of 100 symptomatic and 100 contralateral asymptomatic knees. AJR Am J Roentgenol 2003;81(3):635–641.Google Scholar
  51. 51.
    McCauley TR. MR imaging of chondral and osteochondral injuries of the knee. Radiol Clin North Am 2002;40(5):1095– 1107.PubMedCrossRefGoogle Scholar
  52. 52.
    Hinshaw MH, Tuite MJ, De Smet AA. “Dem bones”: osteochon-dral injuries of the knee. Magn Reson Imaging Clin North Am 2000;8(2):335–348.Google Scholar
  53. 53.
    O'Connor MA, Palaniappan M, Khan N, Bruce CE. Osteochon-dritis dissecans of the knee in children. A comparison of MRI and arthroscopic findings. J Bone Joint Surg Br 2002;84(2): 258–262.PubMedCrossRefGoogle Scholar
  54. 54.
    De Smet AA, Ilahi OA, Graf BK. Untreated osteochondritis dissecans of the femoral condyles: prediction of patient outcome using radiographic and MR findings. Skeletal Radiol 1997;26:463–467.PubMedCrossRefGoogle Scholar
  55. 55.
    Crawford DC, Safran MR. Osteochondritis dissecans of the knee. J Am Acad Orthop Surg 2006;14:90–100.PubMedGoogle Scholar
  56. 56.
    De Smet AA, Fisher DR, Graf BK, Lange RH. Osteochondritis dissecans of the knee: value of MR imaging in determining lesion stability and the presence of articular cartilage defects. AJR Am J Roentgenol 1990;155(3):549–553.PubMedGoogle Scholar
  57. 57.
    Kocher MS, Tucker R, Ganley TJ, Flynn JM. Management of osteochondritis dissecans of the knee. Current concepts review. Am J Sports Med 2006;34: 1181–1191.PubMedCrossRefGoogle Scholar
  58. 58.
    Gil HC, Levine SM, Zoga AC. MRI findings in the subchon-dral bone marrow: a discussion of conditions including transient osteoporosis, transient bone marrow edema syndrome, SONK, and shifting bone marrow edema of the knee. Semin Musculosk-elet Radiol 2006;10:177–186.CrossRefGoogle Scholar
  59. 59.
    Lecouvet FE, Malghem J, Maldague BE, Vande Berg BC. MR imaging of epiphyseal lesions of the knee: current concepts, challenges, and controversies. Radiol Clin North Am 2005;43(4): 655–672.PubMedCrossRefGoogle Scholar
  60. 60.
    Beltran J, Shankman S. Magnetic resonance imaging of bone marrow disorders of the knee. Magn Reson Imaging Clin North Am 1994;2(3):463–473.Google Scholar
  61. 61.
    Boden BP, Osbahr DC. High-risk stress fractures: evaluation and treatment. J Am Acad Orthop Surg 2000;8:344–53.PubMedGoogle Scholar
  62. 62.
    Synder RA, Koester MC, Dunn WR. Epidemiology of stress fractures. Clin Sports Med 2006;25:37–52.CrossRefGoogle Scholar
  63. 63.
    Pepper M, Akuthota V, McMarty EC. The pathophysiology of stress fractures. Clin Sports Med 2006;25:1–16.PubMedCrossRefGoogle Scholar
  64. 64.
    Stanitski CL, McMaster JH, Scranton PE. On the nature of stress fractures. Am J Sports Med 1978;6:391–6.PubMedCrossRefGoogle Scholar
  65. 65.
    Brunet M. Female athlete triad. Clin Sports Med 2005;21: 623–36.CrossRefGoogle Scholar
  66. 66.
    Bennell KL, Malcolm SA, Thomas SA, et al. Risk factors for stress fractures in track and filed athletes. A twelve-month prospective study. Am J Sports Med 1996;24:810–18.PubMedCrossRefGoogle Scholar
  67. 67.
    Sofka CM. Imaging of stress fractures. Clin Sports Med 2006;25:53–62.PubMedCrossRefGoogle Scholar
  68. 68.
    Greaney RB, Gerber FH, Laughlin RL, et al. Distribution and natural history of stress fractures in U.S. marine recruits. Radiology 1983;146:339–46.PubMedGoogle Scholar
  69. 69.
    Gaeta M, Minutoli F, Scribano E, et al. CT and MR imaging findings in athletes with early tibial stress injuries: comparison with bone scintigraphy findings and emphasis on cortical abnormalities. Radiology 2005;235:553–61.PubMedCrossRefGoogle Scholar
  70. 70.
    Arendt EA, Griffiths HJ. The use of MR imaging in the assessment and clinical management of stress reactions of bone in high-performance athletes. Clin Sports Med 1997;16:291–306.PubMedCrossRefGoogle Scholar
  71. 71.
    Rettig AC, Shelbourne KD, McCarroll JR, Bisesi M, Watts J. The natural history and treatment of delayed union stress fractures of the anterior cortex of the tibia. Am J Sports Med 1988;16:250–55.PubMedCrossRefGoogle Scholar
  72. 72.
    Rue JP, Armstrong DW, Frassica FJ, Deafenbaugh M, Wilck-ens JH. The effect of pulsed ultrasound in the treatment of tibial stress fractures. Orthopedics 2004;27:1192–5.PubMedGoogle Scholar
  73. 73.
    Shin AY, Gillingham BL. Fatigue fractures of the femoral neck in athletes. J Am Acad Orthop Surg 1997;5:293–302.PubMedGoogle Scholar
  74. 74.
    Fullerton LR, Snowdy HA. Femoral neck stress fractures. Am J Sports Med 1998;16:365–77.CrossRefGoogle Scholar
  75. 75.
    Johansson C, Ekenman I, Tornkvist H, Eriksson E. Stress fractures of the femoral neck in athletes: the consequences of a delay in diagnosis. Am J Sports Med 1990;18:524–28.PubMedCrossRefGoogle Scholar
  76. 76.
    Swenson EJ, DeHaven KE, Sebastianelli WJ, Hanks G, Kalenak A, Lynch JM. The effect of a pneumatic leg brace on return to play in athletes with tibial stress fractures. Am J Sports Med 1997;25:322–28.PubMedCrossRefGoogle Scholar
  77. 77.
    Young AJ, McAllister DR. Evaluation and treatment of tibial stress fractures. Clin Sports Med 2006;25:117–28.PubMedCrossRefGoogle Scholar
  78. 78.
    Chang PS, Harris RM. Intramedullary nailing for chronic tib-ial stress fractures: a review of five cases. Am J Sports Med 1996;24:688–92.PubMedCrossRefGoogle Scholar
  79. 79.
    Fetzer GB, Wright RW. Metatarsal shaft fractures and fractures of the proximal fifth metatarsal. Clin Sports Med 2005;25: 139–150.CrossRefGoogle Scholar
  80. 80.
    Muscolo L, Migues A, Slullitel G, Costa-Paz M. Stress fracture nonunion at the base of the second metatarsal in a ballet dancer: a case report. Am J Sports Med 2004;32:1535–37.PubMedCrossRefGoogle Scholar
  81. 81.
    Jones GL. Upper extremity stress fractures. Clin Sports Med 2006;25:159–74.PubMedCrossRefGoogle Scholar
  82. 82.
    Ryu KM, Jin W, Ko YT. Bone bruises: MR characteristics and histological correlation in the young pig. J Clin Imaging 200;24:371–80.Google Scholar
  83. 83.
    Vellet AD, Marks PH, Fowler PJ, Muntro TG. Occult post-traumatic osteochondral lesions of the knee: prevalence, classification, and short-term sequelae evaluated with MR imaging. Radiology 1991;28:545–60.Google Scholar
  84. 84.
    Boks SS, Vroebindeweij D, Koes BW, Myriam-Hunink MG, Bierma-Zeinstra SM. Follow-up of occult bone lesions detect at MR imaging. Radiology 2006;238:853–62.PubMedCrossRefGoogle Scholar
  85. 85.
    Mandalia M, Fogg AJB, Chari R, Murray J, Beale A, Henson JHL. Bone bruising of the knee. Clin Radiol 2005;60:627–36.PubMedCrossRefGoogle Scholar
  86. 86.
    Lee JK, Yo L, Phelps CT, Wirth CR, Czajka J, Lozman J. Anterior cruciate ligament tears: MR imaging compared with arthros-copy and clinical tests. Radiology 1988;166:861–4.PubMedGoogle Scholar
  87. 87.
    Zeiss J, Paley K, Murray K. Comparison of bone contusion seen my MRIT in partial and complete tears of the anterior cruciate ligament. J Comput Assit Tomogr 1995;19:773–6.CrossRefGoogle Scholar
  88. 88.
    Johnson DL, Bealle DP, Brand JC, Nyland J, Caborn DNM. The effect of a geographic lateral bone bruise on knee inflammation after acute anterior cruciate ligament rupture. Am J Sports Med 2000;28:152–4.PubMedGoogle Scholar
  89. 89.
    Mair SD, Schlegel TF, Gill TJ, Hawkins RJ, Steadman JR. Incidence and location of bone bruises after acute posterior cruciate ligament injury. Am J Sports Med 2004;32: 1681–87.PubMedCrossRefGoogle Scholar
  90. 90.
    Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR. Bone contusions of the posterior lip of the medial tib-ial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. Radiology 1989;211:747–53.Google Scholar
  91. 91.
    Wright RW, Phaneuf MA, Limbird TJ, Spindler KP. Clinical outcome of isolated subcortical trabecular fractures (bone bruise) detected on magnetic resonance imaging in knees. Am J Sports Med 2000;28:663–7.PubMedGoogle Scholar
  92. 92.
    Faber K, Dill J, Thain L. Intermediate follow-up of occult osteo-chondral lesions following ACL reconstruction. Arthroscopy 1996;12:370–71.Google Scholar
  93. 93.
    Mora SA, Mandelbaum BR, Byrd JWT. Hip and pelvis. In: Gar-rick JG, ed. Orthopaedic Knowledge Update: Sports Medicine 3. Rosemont, IL: American Academy of Orthopaedic Surgery, 2004:139–42.Google Scholar
  94. 94.
    Mellado JM, Ramos A, Salvado E, Camins A, Calmet J, Sauri A. Avulsion fractures and chronic avulsion injuries of the knee: role of MR imaging. Eur Radiol 2002;12:2463–73.PubMedGoogle Scholar
  95. 95.
    Tuite MJ, Kijowski R. Sports-related injuries of the elbow: an approach to MRI interpretation. Clin Sports Med 2006;25:387–408.PubMedCrossRefGoogle Scholar
  96. 96.
    Morrison WB. Magnetic resonance imaging of sports injuries of the ankle. Topics MR Imaging 2003;14:179–98.CrossRefGoogle Scholar
  97. 97.
    Mankin HJ. Nontraumatic necrosis of bone (osteonecrosis). N Engl J Med 1992;326:1473–9.PubMedGoogle Scholar
  98. 98.
    Lavernia CJ, Sierra RJ, Grieco FR. Osteonecrosis of the femoral head. J Am Acad Orthop 1999;7:250–61.Google Scholar
  99. 99.
    Cushner MA, Friedman RJ. Osteonecrosis of the humeral head. J Am Acad Orthop 1997;5:339–46.Google Scholar
  100. 100.
    Mont MA, Hungerford DS. Non-traumatic avascular necrosis of the femoral head. J Bone Joint Surg Am 1995;77:459–74.PubMedGoogle Scholar
  101. 101.
    Kokubo T, Takatori Y, Ninomiya S, Nakamura T, Kamogawa M. Magnetic resonance imaging and scintigraphy of avascular necrosis of the femoral head. Prediction of subsequent segmen-tal collapse. Clin Orthop Rel Res 1992;277:54–60.Google Scholar
  102. 102.
    Allan CH, Joshi A, Lichtman DM. Kienbock's disease: diagnosis and treatment. J Am Acad Ortho 2001;9:128–36.Google Scholar
  103. 103.
    Marciniak D, Furey C, Shaffer JW. Osteonecrosis of the femoral head. A study of 101 hips treated with vascularized fibular grafting. J Bone Joint Surg Am 2005;87:742–47.PubMedCrossRefGoogle Scholar
  104. 104.
    Ecker ML, Lotke PA. Spontaneous osteonecrosis of the knee. J Am Acad Ortho 1994;2:173–78.Google Scholar
  105. 105.
    Marulanda G, Seyler TM, Sheikh NH, Mont MA. Percutaneous drilling for the treatment of secondary osteonecrosis of the knee. J Bone Joint Surg Br 2006;88:740–46.PubMedCrossRefGoogle Scholar
  106. 106.
    Jamali AA, Emmerson BC, Chung C, Convery FR, Bugbee WD. Fresh osteochondral allografts. Clin Orthop Rel Res 2005;437:176–85.Google Scholar
  107. 107.
    Fortin PT, Balazsy JE. Talus fractures: evaluation and treatment. J Am Acad Orthop 2001;9:114–27.Google Scholar
  108. 108.
    Meehan R, McFarlin S, Bugbee W, Brage M. Fresh ankle osteo-chondral allograft transplantation for tibiotalar joint arthritis. Foot Ankle Int 2005;26:793–802.PubMedGoogle Scholar
  109. 109.
    Canale T. Campbell's Operative Orthopaedics, 10th ed. St. Louis: Mosby, 2003.Google Scholar

Copyright information

© Springer Science + Business Media B.V. 2008

Authors and Affiliations

  • Sailaja Yadavalli
    • 1
  • Donald Resnick
    • 2
  • Catherine Robertson
    • 3
  • Ryan Serrano
    • 4
  • Robert A. Pedowitz
    • 5
  1. 1.Department of Diagnostic RadiologyWilliam Beaumont HospitalRoyal OakUSA
  2. 2.Department of RadiologyUniversity of CaliforniaSan DiegoUSA
  3. 3.Department of Orthopaedic SurgeryUniversity of CaliforniaSan DiegoUSA
  4. 4.Occidental CollegeLos AngelesUSA
  5. 5.Department of Orthopaedics and Sports MedicineUniversity of South Florida College of MedicineTampaUSA

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