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Document Title: Johnson-AJSM-Mar00
Article Title: The effect of a geographic lateral bone
bruise on knee inflammation after acute anterior cruciate ligament rupture
Author: Darren L. Johnson; David P. Bealle, Jefferson C. Brand Jr, John Nyland, David N.M. Caborn.
Publication: The American Journal of Sports Medicine
ISSN: 03635465
Date: March-April 2000.
(This article does not have figures. Reference-denoting numbers appear in the same point size as document text.)
Volume: 28
Issue: 2
Pages: 152-155
Key Words: Knee, injuries, bone bruising, chondral, articular, cartilage, ACL, bone.
ABSTRACT
We prospectively evaluated 40 patients who had knee
inflammation after isolated anterior cruciate ligament rupture with or without
an associated "geographic" bone bruise/subchondral fracture of the
lateral femoral condyle. All patients with acute ruptures documented by
magnetic resonance imaging within 1 week of injury were evaluated for a
geographic bone bruise/subchondral fracture of the lateral femoral condyle. Two
groups of 20 patients each (bone bruise versus no bone bruise) were then
enrolled. Variables measured at 1, 2, 3, and 4 weeks after injury included
pain, range of motion, effusion, and number of days with an antalgic gait (i.e.
limping). Patients with a bone bruise had increased size and duration of
effusion, increased number of days required to nonantalgic gait without
external aids, increased days to achieve normal range of motion, and increased
pain scores at measured time intervals. This study confirms results of previous
clinical and histologic studies showing an associated articular cartilage
lesion, otherwise known as bone bruise/subchondral fracture, is clinically
significant. There appears to be an association between a geographic bone
bruise and increased disability in patients with acute anterior cruciate
ligament ruptures. Patients with a geographic bone bruise may require longer to
reach normal homeostasis (range of motion, pain, neuromuscular control) before
undergoing anterior cruciate ligament reconstruction.
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