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. 2023 Feb 24;11(2):23259671221146205.
doi: 10.1177/23259671221146205. eCollection 2023 Feb.

Relationship Between Bone Bruise Volume and Patient Outcomes After ACL Reconstruction

Connor Galloway  1 , Hallie Ward  1 , Steven Higbie  1 , Jacquelyn Kleihege  1 , Manickam Kumaravel  2 , Walter R Lowe  3 , Lane Bailey  1
Affiliations

Relationship Between Bone Bruise Volume and Patient Outcomes After ACL Reconstruction

Connor Galloway et al. Orthop J Sports Med. .

Abstract

Background: Subchondral bone injuries, or bone bruises, are commonly observed on magnetic resonance imaging (MRI) after anterior cruciate ligament (ACL) injury. The current relationship between bone bruise volume and postsurgical outcomes remains poorly understood.

Purpose: To examine the influence of bone bruise volume on self-reported and objective functional outcomes at the time of return to play and 2 years following ACL reconstruction.

Study design: Cohort study; Level of evidence, 3.

Methods: Clinical, surgical, and demographic data were obtained for a sample of convenience utilizing a single-surgeon ACL database (n = 1396). For 60 participants, femoral and tibial bone bruise volumes were estimated from preoperative MRI. Data obtained at the time of return to play included International Knee Documentation Committee (IKDC-2000) score, ACL-Return to Sport after Injury (ACL-RSI) score, and performance on an objective functional performance battery. Two-year follow-up data included graft reinjury rate, level of return to sport/activity, and self-reported knee function using the Single Assessment Numeric Evaluation (SANE). The forward stepwise linear regression was used to determine the relationship between bone bruise volume and patient function.

Results: The distribution of bone bruise injuries was as follows: lateral femoral condyle (76.7%), lateral tibial plateau (88.3%), medial femoral condyle (21.7%), and medial tibial plateau (26.7%). Mean total bone bruise volume of all compartments was 7065.7 ± 6226.6 mm3. At the 2-year follow up, there were no significant associations between total bone bruise volume and time of return to play (P = .832), IKDC-2000 score (P = .200), ACL-RSI score (P = .370), or SANE score (P = .179).

Conclusion: The lateral tibial plateau was the most frequent site to sustain bone bruise injury. Preoperative bone bruise volume was not associated with delayed time to return to sport or self-reported outcomes at time of return to play or at 2 years postoperatively.

Registration: NCT03704376 (ClinicalTrials.gov identifier).

Keywords: bone bruise; return to sport.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: M.K. has received hospitality payments from Canon Medical Systems USA, GE Healthcare, and Siemens Medical Solutions USA. W.R.L. has received education payments from Medinc of Texas, consulting fees from DJO and Medinc of Texas, nonconsulting fees from Arthrex, royalties from Arthrex, and hospitality payments from Linvatec. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Proton-density coronal magnetic resonance imaging scan showing hyperintense region of interest (outlined in yellow) for the lateral femoral condyle.
See this image and copyright information in PMC

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