Keywords:
Musculoskeletal joint, Musculoskeletal bone, MR, Diagnostic procedure, Athletic injuries, Oedema
Authors:
B. Ciszkowska-Lyson, B. Dominik, U. Zdanowicz, R. Smigielski; Warsaw/PL
DOI:
10.1594/ecr2018/C-3210
Methods and materials
The study was retrospective in nature.
Initially,
it covered 3196 patients with a knee injury,
who were admitted between 2011 and 2013.
Following the preliminary selection process,
the list of 697 subjects diagnosed with an ACL injury (grades I to III per AMA CMAS guidelines),
both chronic and acute,
was made.
After further analysis,
MRIs from 336 cases of acute complete ACL rupture (grade III) were retrieved.
The selection criteria for the study group,
on whose MRIs the classification is based,
included: the time between the injury and the first MRI (acute injury,
i.e.
0 days - 32 weeks); the extent of the damage (partial or complete); and the occurrence of bone bruising indicated on an MRI scan.
Ultimately,
out of the 336 initially retrieved cases,
the study group included 220 patients (73 females and 147 males,
in the age range of 11-76 years old; mean 37,32 years) with an acute complete ACL rupture (grade III),
whose MRI indicated bone bruising in the area of the posterior margin of the tibia (PTM).
A 1.5Tesla GE Signa HDXt machine was used.
The evaluation process included assessment in all available planes,
however the basis for the classification were sagittal PD images.
The slice thickness was either 3/0mm or 3/03mm or less.
The extent of the damage was assessed through the analysis of the retrieved MRIs conducted by an experienced radiologist specializing in orthopedic assessment.
In general,
the choice of the plane depended on its usefulness in revealing the fracture,
thus in some cases,
two slices were needed.
To classify the damage to the posterior margin of the tibia,
we were looking for the sagittal cross-section best revealing the fracture,
and then we were correlating it with the plateau’s surface normally dedicated to the lateral meniscus.
In the next step,
we were analyzing whether the meniscus remains fully supported or if the compression of the bone led to the decrease in LM’s support.
No specific measurements were taken,
the level of support was determined in percent’s.