Bone Contusions With ACL Rupture Associated With More Ligament Injuries

The prevalence of meniscal and medial collateral ligament (MCL) injuries increases with the increased extent of bone contusions in patients with anterior cruciate ligament (ACL) rupture. A higher-energy injury may result in a more extensive bone contusion and a higher prevalence of associated injury.

Yoon and coworkers conducted a retrospective study of patients who underwent ACL reconstruction surgery, including only patients for whom an MRI scan had been obtained within 6 weeks after the ACL injury. Bone contusions were documented. Meniscal tears were detected during arthroscopy. MCL injuries were classified on MRI.

Of the 81 knees, 68 (84%) had bone contusions on MRI. The prevalence of bone contusions in the lateral femoral condyle, lateral aspect of the tibial plateau, medial femoral condyle, and medial aspect of the tibial plateau was 68%, 73%, 24%, and 26%, respectively. The overall prevalences of injury to the lateral meniscus, medial meniscus, and MCL were 54%, 51%, and 22% respectively; the prevalences of these injuries increased as the bone contusion progressed from being absent to involving only the lateral compartment to involving both lateral and medial compartments.

The authors noted that bone contusion on the medial side occurs more frequently than previously thought.

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