Biomechanics Laboratory, College of Human Movement Science, Beijing Sport University, Beijing, 100084, China.
Division of Physical Therapy, Center for Human Movement Science, School of Medicine, The University of North Carolina at Chapel Hill, CB# 7135 Bondurant Hall, Chapel Hill, NC, 27599-7135, USA.
Sports Med. 2019 Mar;49(3):453-462. doi: 10.1007/s40279-019-01060-6.
Anterior cruciate ligament (ACL) injury is one of the most common injuries in sports, and the injury mechanisms are not completely clear. Bone bruises seen on magnetic resonance imaging (MRI) following ACL injuries may provide significant information for determining ACL injury mechanisms.
The aim was to determine ACL injury mechanisms through an evaluation of locations of bone bruises associated with ACL injury.
A search for related articles in PubMed and the EBSCO Sport Database was performed using selected search strings from inception to August 6, 2018. Original studies with specified bone bruise locations identified using MRI technology were reviewed.
A total of 12 studies with 589 patients were selected for review. A total of 471 bone bruises in the lateral tibial plateau were reported. Of these bone bruises, 409 (87%) occurred in the posterior section. A total of 242 bone bruises in the medial tibial plateau were reported. Of these bone bruises, 208 (86%) occurred in the posterior section. A total of 266 bone bruises in the lateral femoral condyle were reported. Of these bone bruises, 65 (25%) and 184 (69%) occurred in the anterior and central sections, respectively. A total of 105 bone bruises in the medial femoral condyle were reported. Of these bone bruises, 49 (47%) and 41 (39%) occurred in the anterior and central sections, respectively.
Bone bruise location patterns indicate that tibial anterior translation relative to the femur was a primary injury mechanism in the majority of ACL injuries selected in this review, and that the maximal knee valgus apparently occurred after tibial anterior translation sufficient to injure the ACL. Bone bruise location patterns also indicate knee hyper-extension as another mechanism of non-contact ACL injury.
前交叉韧带（ACL）损伤是运动中最常见的损伤之一，其损伤机制尚不完全清楚。ACL 损伤后磁共振成像（MRI）上可见的骨挫伤可为确定 ACL 损伤机制提供重要信息。
旨在通过评估与 ACL 损伤相关的骨挫伤位置来确定 ACL 损伤机制。
从建库到 2018 年 8 月 6 日，在 PubMed 和 EBSCO 运动数据库中使用选定的搜索词进行了相关文章的检索。对使用 MRI 技术确定特定骨挫伤位置的原始研究进行了回顾。
共选择了 12 项研究 589 例患者进行综述。共报告了外侧胫骨平台 471 处骨挫伤。这些骨挫伤中，409 处（87%）发生在后段。共报告了内侧胫骨平台 242 处骨挫伤。这些骨挫伤中，208 处（86%）发生在后段。共报告了外侧股骨髁 266 处骨挫伤。这些骨挫伤中，65 处（25%）和 184 处（69%）分别发生在前段和中段。共报告了内侧股骨髁 105 处骨挫伤。这些骨挫伤中，49 处（47%）和 41 处（39%）分别发生在前段和中段。
骨挫伤位置模式表明，在本综述中选择的大多数 ACL 损伤中，胫骨相对于股骨的前向平移是主要的损伤机制，而明显的最大膝外翻显然发生在足以损伤 ACL 的胫骨前向平移之后。骨挫伤位置模式还表明，膝关节过伸是另一种非接触性 ACL 损伤机制。
