PROSPECTIVE-STUDY OF OSSEOUS, ARTICULAR, AND MENISCAL LESIONS IN RECENT ANTERIOR CRUCIATE LIGAMENT TEARS BY MAGNETIC-RESONANCE-IMAGING AND ARTHROSCOPY

Fifty-four patients with anterior cruciate ligament tears that were ar throscopically reconstructed within 3 months of initial injury were pr ospectively evaluated. Patients with grade 3 medial collateral ligamen t, lateral collateral ligament, or posterior cruciate ligament tears w ere excluded. Eighty percent of our patients had a bone bruise present on the magnetic resonance image, with 68% in the lateral femoral cond yle. Two of the latter findings-an abnormal articular cartilage signal (P = 0.02) and a thin and impacted subchondral bone (P = 0.03)-had a significant relationship with injury to the overlying articular cartil age. Meniscal tears were found in 56% of the lateral menisci and 37% o f the medial menisci. A significant association was present between bo ne bruising on the lateral femoral condyle and the lateral tibial plat eau (P = 0.02). Results of our study support the concept that the comm on mechanism of injury to the anterior cruciate ligament involves seve re anterior subluxation with impaction of the posterior tibia on the a nterior femur. Determination of the significance of bone bruising, art icular cartilage injury, or meniscal tears will require a long-term fo llowup that includes evaluation for arthritis, stability, and function . These 54 patients represent the first cohort evaluated in this ongoi ng prospective clinical study.