Correlation Between the Location and Distance of Kissing Contusions and Knee Laxity in Acute Noncontact ACL Injury

医学 前交叉韧带 前外侧韧带 前交叉韧带损伤 瘀伤 磁共振成像 急性损伤 损伤严重程度评分 关节镜检查 射线照相术 核医学 外科 放射科 毒物控制 前交叉韧带重建术 伤害预防 环境卫生
作者
Junqiao Li,Yunhe Mao,Duan Wang,Weili Fu,Qi Li,Xin Tang,Gang Chen,Xi Chen,Lei Yao,Mingke You,Yan Xiong,Jian Li
出处
期刊:American Journal of Sports Medicine [SAGE Publishing]
卷期号:51 (12): 3179-3189 被引量:5
标识
DOI:10.1177/03635465231196865
摘要

Bone bruise (BB) and kissing contusion are common features of acute anterior cruciate ligament (ACL) injury on magnetic resonance imaging (MRI). The correlation between the location and distance of kissing contusions and knee laxity remains unclear.To determine the significance of different patterns of BB in acute noncontact ACL injury and assess the correlation between the location and distance of kissing contusions and the severity of knee laxity.Cross-sectional study; Level of evidence, 3.A total of 205 patients with acute noncontact ACL injury undergoing arthroscopic treatment between January 2021 and May 2022 were included in this retrospective analysis. Patients were grouped according to the different patterns of BB. The type of ACL injury and concomitant injuries were analyzed on MRI and confirmed by arthroscopy. Anterior knee laxity was assessed by the Ligs digital arthrometer and stress radiography, and rotational knee laxity was assessed by the intraoperative pivot-shift test. The MRI parameters of the location and distance of kissing contusions were measured to assess their correlations with the severity of knee laxity.Of the 205 patients with acute noncontact ACL injury, 38 were in the non-BB group and 167 were in the BB group, the latter including 32 with the isolated BB on the lateral tibial plateau and 135 with kissing contusions. There was no significant difference in the mean time from initial injury to MRI scan between the non-BB group and the BB group (14.34 ± 2.92 vs 15.17 ± 2.86 days; P = .109) or between the isolated BB subgroup and the kissing contusion subgroup (14.94 ± 2.92 vs 15.23 ± 2.85 days; P = .605). The side-to-side difference (SSD) in anterior knee laxity and the incidences of complete ACL injury, concomitant injuries, and high-grade pivot-shift test were significantly higher in the BB group than in the non-BB group, and in the kissing contusion subgroup compared with the isolated BB subgroup. The kissing contusion index of the lateral femoral condyle (LFC) and the sagittal distance of kissing contusions were significantly correlated with the SSD in anterior knee laxity and the grade of pivot-shift test (P < .001).The presence of BB, in particular the appearance of kissing contusions, was related to greater knee laxity and higher incidences of complete ACL injury and concomitant injuries in acute noncontact ACL injury. For patients with kissing contusions, as the location of BB on the LFC moved forward and the distance between kissing contusions increased, anterior and rotational knee laxity became more serious.
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