Superficial and deep medial collateral ligament injuries associated with bone contusion patterns after ACL injury

Superficial and deep medial collateral ligament injuries associated with bone contusion patterns after ACL injury

Seong Man Jeon, MD, KOREA, REPUBLIC OF Joon Ho Wang, MD, PhD, KOREA, REPUBLIC OF Joo-Hwan Kim, MD, KOREA, REPUBLIC OF Kyeong Baek Kim, MD, KOREA, REPUBLIC OF

Samsung Medical Center, Seoul, Seoul, KOREA, REPUBLIC OF


2025 Congress   ePoster Presentation   2025 Congress   Not yet rated

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Ligaments

ACL

Diagnosis Method

MRI

Sports Medicine

Treatment / Technique

Bones


Summary: A significant bone contusion in the lateral compartment was associated with sMCL injury, and a bone contusion in the medial compartment was associated with dMCL injury.


Background

Undiagnosed meniscus and ligament injury associated with ACL injury results in poor prognosis of ACL reconstruction. Accurate diagnosis and treatment of concomitant injuries is critical for successful ACL reconstruction.

Purpose

The purpose of this study was to identify correlation between superficial and deep medial collateral ligament injuries and bone contusion patterns which is closely related with ACL injury mechanism.

Methods

The study was conducted on patients who underwent ACLR at our hospital from August 2023 to September 2021. Bone contusion patterns were classified according to the related injury mechanism. (1) A minimal bone contusion in the lateral compartment. (2) A significant bone contusion in the lateral compartment. (3) A bone contusion in the medial compartments. Injuries to the MPFL, superficial MCL, deep MCL, posterior oblique ligament, LCL, and meniscus were identified and correlated with each bone contusion patterns.

Results

A total of 148 patients met the criteria from a total of 292 ACLR cases. 40 patients had a minimal bone contusion in the lateral compartment, 56 patients had a significant bone contusion in the lateral compartment, and 75 patients had a bone contusion in the medial compartments. The minimal bone contusion in the lateral compartment demonstrated a significantly lower incidence of RAMP lesions(P = .024), partial and complete tears of the dMCL(P = .006, P < .001, respectively). In contrast, the significant bone contusion in the lateral compartment exhibited a significantly higher prevalence of partial and complete tears of the sMCL(P = .002, P = .002, respectively) and complete tears of the MPFL(P = .003). The bone contusion in the medial compartments showed a significantly higher incidence of RAMP lesions(P < .001), partial and complete tears of the dMCL(P = .013, P < .001, respectively), and a significantly lower incidence of complete tears of the sMCL(P = .006).

Conclusion

A significant bone contusion in the lateral compartment was associated with sMCL injury, and a bone contusion in the medial compartment was associated with dMCL injury.

Clinical relevance
Analyzing bone contusion patterns of ACL injury can help accurately diagnose concomitant meniscus and ligament injuries and determine a treatment strategy.