Relationship Between Bone Bruise Volume and Patient Outcomes After ACL Reconstruction

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Radiology

Background:

• Subchondral bone injuries, or bone bruises, are frequently detected via MRI following anterior cruciate ligament (ACL) injury.
• The correlation between bone bruise volume and post-surgical outcomes after ACL reconstruction is not well-established.

Purpose of the Study:

• To investigate the impact of bone bruise volume on patient-reported and objective functional outcomes.
• To assess outcomes at the time of return to play and at the 2-year follow-up mark after ACL reconstruction.

Main Methods:

• A cohort study (Level of evidence, 3) analyzed data from 1396 patients in a single-surgeon ACL database.
• Preoperative MRI was used to estimate femoral and tibial bone bruise volumes in 60 participants.
• Functional outcomes included IKDC-2000, ACL-RSI scores, and a functional performance battery at return to play, with graft reinjury and SANE scores at 2-year follow-up.

Main Results:

• The lateral femoral condyle (76.7%) and lateral tibial plateau (88.3%) were the most common sites for bone bruises.
• Mean total bone bruise volume was 7065.7 ± 6226.6 mm³.
• No significant associations were found between total bone bruise volume and time to return to play, IKDC-2000, ACL-RSI, or SANE scores at 2 years.

Conclusions:

• Bone bruise injuries are most prevalent on the lateral tibial plateau.
• Preoperative bone bruise volume did not correlate with delayed return to sport or patient-reported outcomes at either the return-to-play stage or 2 years post-surgery.