Osseous injury associated with acute tears of the anterior cruciate ligament

Am J Sports Med. 1992 Jul-Aug;20(4):382-9. doi: 10.1177/036354659202000403.


Multiplanar spin-echo magnetic resonance imaging was performed on 54 patients with acute complete anterior cruciate ligament tears. Imaging was done within 45 days of index anterior cruciate ligament injury. Spin-echo T1- and T2-weighted images were used to determine the lesion morphology and location. Only the T2-weighted sagittal images were used for the incidence assessment; T2-weighted spin-echo imaging reflects free water shifts and best indicates the acute edema and inflammatory changes from injury. Eighty-three percent (45 of 54) of the knees had an osseous contusion directly over the lateral femoral condyle terminal sulcus. The lesion was highly variable in size and imaging intensity; however, the most intense signal was always contiguous with the subchondral plate. Posterolateral joint injury was seen in 96% (43 of 45) of the knees that had a terminal sulcus osseous lesion determined by magnetic resonance imaging. This posterolateral lesion involves a spectrum of injury, including both soft tissue (popliteus-arcuate capsuloligamentous complex) and hard tissue (posterolateral tibial plateau) injuries. The consistent location of the osseous and soft tissue injuries underscores a necessary similar mechanism of injury associated with these acute anterior cruciate ligament tears. Based on these characteristic findings, several proposed mechanisms of injury are discussed.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Anterior Cruciate Ligament / pathology
  • Anterior Cruciate Ligament Injuries*
  • Female
  • Femur / injuries*
  • Humans
  • Knee Injuries / diagnostic imaging
  • Knee Injuries / pathology
  • Magnetic Resonance Imaging
  • Male
  • Radiography
  • Retrospective Studies
  • Sprains and Strains / pathology