Galloway Connor, Ward Hallie, Higbie Steven, Kleihege Jacquelyn, Kumaravel Manickam, Lowe Walter R, Bailey Lane
Department of Sports Medicine and Rehabilitation, Memorial Hermann Rockets Sports Medicine Institute, Houston, Texas, USA.
Department of Diagnostic and Interventional Imaging, McGovern Medical School at UT Health, Houston, Texas, USA.
Orthop J Sports Med. 2023 Feb 24;11(2):23259671221146205. doi: 10.1177/23259671221146205. eCollection 2023 Feb.
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.
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.
Cohort study; Level of evidence, 3.
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.
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 mm. At the 2-year follow up, there were no significant associations between total bone bruise volume and time of return to play ( = .832), IKDC-2000 score ( = .200), ACL-RSI score ( = .370), or SANE score ( = .179).
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.
NCT03704376 (ClinicalTrials.gov identifier).
在磁共振成像（MRI）上，前交叉韧带（ACL）损伤后常可观察到软骨下骨损伤（即骨挫伤）。目前，骨挫伤体积与术后结果之间的关系仍知之甚少。
研究骨挫伤体积对ACL重建术后恢复运动时以及术后2年的自我报告功能结局和客观功能结局的影响。
队列研究；证据等级：3级。
利用单外科医生的ACL数据库（n = 1396），方便抽取样本获取临床、手术及人口统计学数据。对60名参与者，根据术前MRI估算股骨和胫骨的骨挫伤体积。恢复运动时获取的数据包括国际膝关节文献委员会（IKDC-2000）评分、ACL损伤后恢复运动（ACL-RSI）评分以及客观功能表现测试的结果。2年随访数据包括移植物再损伤率、恢复运动/活动水平以及使用单项评估数字评定法（SANE）进行的自我报告膝关节功能。采用向前逐步线性回归确定骨挫伤体积与患者功能之间的关系。
骨挫伤损伤分布如下：外侧股骨髁（76.7%）、外侧胫骨平台（88.3%）、内侧股骨髁（21.7%）和内侧胫骨平台（26.7%）。所有区域的平均总骨挫伤体积为7065.7±6226.6立方毫米。在2年随访时，总骨挫伤体积与恢复运动时间（P = 0.832）、IKDC-2000评分（P = 0.200）、ACL-RSI评分（P = 0.370）或SANE评分（P = 0.179）之间均无显著关联。
外侧胫骨平台是最常发生骨挫伤损伤的部位。术前骨挫伤体积与恢复运动延迟时间或恢复运动时及术后2年的自我报告结局无关。
NCT03704376（ClinicalTrials.gov标识符）
