急性前交叉韧带断裂合并膝关节骨挫伤的临床研究

目的 :总结前交叉韧带急性断裂时骨挫伤的不同类型和分布 ,探讨骨挫伤与关节软骨损伤的关系。方法 :回顾性研究 37例前交叉韧带急性断裂合并膝关节骨挫伤患者的影像学和临床资料 ,分析前交叉韧带急性断裂时骨挫伤的MRI不同表现类型、分布以及关节镜下软骨损伤的情况。结果 :MRI显示本组病例骨挫伤共 5 7处 ,其中Ⅰ型 1 4处 (2 4 .6 %) ,Ⅱ型 32处 (5 6 .1 %) ,Ⅲ型 3处(5 .3%) ,Ⅳ型 6处 (1 0 .5 %) ,Ⅴ型 2处 (3.5 %)。共 5 4处 (94 .7%)骨挫伤位于外侧间室 ,其中股骨外髁骨挫伤 31处 ,胫骨外侧平台骨挫伤 2 3处。经关节镜下手术发现 9处 (1 5 .8%)骨挫伤部位有软骨损伤表现。结论 :急性前交叉韧带断裂时 ,骨挫伤通常发生在外侧间室 ,尤其集中在外侧股骨髁前部以及外侧胫骨平台后部。关节镜下软骨损伤与骨挫伤并非一一对应的关系。

MRI Findings of Bone Bruises Associated with Acute Anterior Cruciate Ligament Ruptures

Objective To study the magnetic resonance imaging (MRI) characteristic of bone bruises associated with acute anterior cruciate ligament (ACL) ruptures and to investigate the correlation between bone bruises and cartilage lesions. Methods The MRI findings of 37 cases of acute ACL ruptures associated with bone bruises were studied retrospestively. The classification and distribution of bone bruises were analyzed and the cartilage lesions were also observed under arthroscopy. Results A total of 57 independent bone bruises(type Ⅰ:14, type Ⅱ:32, type Ⅲ:3, type Ⅳ:6 and type Ⅴ:2) were documented by MRI in the 37 patients. 54 (94.7%) bone bruises located in lateral joint compartment with involvement of lateral femoral condyle in 31 and lateral tibial plateau in 23. Nine cases (15.8%) of articular cartilage lesions were found under arthroscopy in the area overlying bone bruises. Conclusion Bone bruises associated with acute ACL ruptures mainly located in the lateral compartment of knee, especially in anterior portion of lateral femoral condyle and posterior portion of lateral tibial plateau. Arthroscopic cartilage lesions were not corresponding to bone bruises.