Detaillierte Beitrags-Information
| Beitragstitel | Bone bruise characteristics in the pediatric population with anterior cruciate ligament tears |
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| Beitragscode | P060 |
| Autoren | |
| Präsentationsform | Poster |
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| Abstract |
Introduction During ACL injury, the external forces responsible for ligament rupture can cause a violent impact between the tibial and femoral articular cartilage, which is transferred to bone, resulting in bone bruise. As such, bone bruise characteristics could be an important aspect to better understand the level of joint derangement While this has been widely investigated in adults, the literature still lacks information about younger patients, where intrinsic differences in terms of ligamentous laxity may lead to different lesion patterns. Purpose of this study is to investigate bone bruise associated with ACL rupture in the pediatric population, to clarify the possible impact on joint homeostasis. Methods MRIs of the knee of patients aged 8 to 16 years with ACL tears have been selected from the Institution database. Inclusion criteria were open or at least partially open physis, time between trauma and MRI less than 90 days and no history of prior injury or surgery. Presence of bone bruise, its localization and size were analyzed by two researchers blinded to radiologist’s reports and scored with Whole Organ Magnetic Resonance Imaging Score (WORMS). Moreover, ligaments, cartilaginous, meniscal, or other lesions were documented. Results Among the selected 78 patients with ACL tears, 54 had bone bruise for a 69% prevalence. Mean area of bone bruise differed between females, where it was 2.2 ± 1.4 cm2 in the femur and 1.5 ± 0.8 cm2 in the tibia, and males, who had 3.8 ± 2.8 cm2 in the femur and 2.6 ± 1.6 cm2 in the tibia (p=0.006 in femur; p=0.007 in tibia). Sub-regions mostly affected were lateral posterior tibia and lateral central femur that were involved in 83% and 80% of the knees with bone bruise, respectively. There were low relationship between age and bone bruise area or WORMS (age-area r=0.25; age-WORMS r=0.31). Other injuries associated with bone bruise were 10 ligamentous lesions(18.0%), 3 cartilaginous lesions(5.5 %); 17 meniscal lesions(31.0%); and 1 patellar fracture(1.8%). Non significance has been seen with patients with ACL tear and no bone bruise. Conclusion The prevalence of bone bruise in pediatric patients with ACL tears is high, although slightly lower than what documented in adults. The area and the distribution pattern of bone bruise are similar among different ages. The low presence of cartilaginous lesions with respect to what reported in adults suggests a different impact of this trauma on the knee joint in pediatric patients. |