Abstract
The anterior cruciate ligament (ACL) is an important stabilizer of the knee joint. At the time of ACL disruption, the “bone bruise” sustained during pivot shift and tibial translation has been recognized as a transchondral fracture of varying severity. Little is known, however, about the risk factors of osteoarthritis following initial ACL injury, or the effect on cartilage morphology following the initial transchondral fracture. Because of its direct multiplanar capabilities and superior soft-tissue contrast, as well as the availability of reproducible, standardized, and surgically validated cartilage pulse sequences, magnetic resonance imaging (MRI) is an extremely well-suited tool to provide objective longitudinal evaluation of cartilage changes following ACL disruption. In a young cohort of patients (mean age, twenty-six years) who sustained an ACL tear, the investigators performed a longitudinal, comprehensive, prospective MRI analysis, using standardized three-dimensional pulse sequences to evaluate morphologic changes and cartilage thickness as well as the extent of subchondral bone marrow edema pattern and joint fluid volume. The patients were captured from a prior randomized controlled trial comparing delayed versus acute ACL reconstruction with a clinical rehabilitation regimen alone. The investigation disclosed significant cartilage thickening in the central portion of the medial femoral condyle, associated with an older age at the time of the ACL tear, …
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