KEYSTONE, COLO. — A bone bruise within the knee that occurs at the time of an anterior cruciate ligament injury does not predispose the patient to later bone or cartilage damage, according to a study of 44 patients seen 12 years after their reconstruction operation.
Prior to this study, it had been presumed that a bone bruise seen with MRI at the time of an acute anterior cruciate ligament (ACL) injury might lead to later degenerative changes because bruising can be associated with necrosis of osteocytes and subchondral bone.
In this study, however, bruising at the time of injury did not consistently lead to an articular cartilage lesion, said Bryan T. Hanypsiak, M.D., at the annual meeting of the American Orthopaedic Society for Sports Medicine.
Among the 44 patients, 80% had a bone bruise at the time of their injury. Most commonly the injury was on the lateral femoral condyle (64%).
MRI imaging was performed at the time of follow-up and no persistent residual bruise was seen in any of the patients, said Dr. Hanypsiak of East Setauket, N.Y.
The mean International Knee Documentation Committee (IKDC) score of patients with bruising was 70 at follow-up compared with 70.6 for those without bruising.
There was no correlation between an articular cartilage injury at the time of injury and articular cartilage lesions at follow-up. All appeared to have resolved, and the mean IKDC score of those with an articular cartilage lesion at the time of injury was 69 at follow-up vs. 72 in those without a cartilage lesion.
Fifteen of the study patients had subsequent knee surgery, most commonly for a meniscal tear.