Comparison Between Sexes of Bone Contusions and Meniscal Tear Patterns in Noncontact Anterior Cruciate Ligament Injuries.

Published

Journal Article

BACKGROUND: Valgus load has been linked to female predominance and mechanism for noncontact anterior cruciate ligament (ACL) injuries. Magnetic resonance imaging (MRI) studies reporting frequent medial contusions in noncontact ACL injuries suggest anterior translation rather than a valgus mechanism. HYPOTHESIS: Bone contusion and meniscal tear patterns differ between sexes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: This study included a review of clinic notes, operative reports, and MRI of patients younger than 20 years who underwent acute primary ACL reconstruction for a noncontact injury between January 1, 2005, and January 1, 2010. A blinded musculoskeletal MRI radiologist reported the incidence of medial and lateral femoral and tibial bone contusions on MRI, as well as the severity of medial versus lateral tibial contusions. The location of the bone contusions and meniscal tears and the maximal tibial contusion severity were compared through chi-square analysis (statistical significance, P < .05). RESULTS: A total of 73 patients met inclusion criteria: 28 males, 45 females; mean age, 16.1 ± 1.7 years (males), 16.5 ± 1.7 years (females). No significant differences were noted between sexes for location of tibial contusions (P = .32), femoral contusions (P = .44), or meniscal tears (P = .715). The most common tibial contusion pattern was to have both medial and lateral tibial contusions, in both male (57%) and female (60%) patients. The most common femoral contusion pattern was lateral only in females (62%) and both medial and lateral in males (50%). The percentage of female (29%) and male (29%) patients with isolated medial meniscal tears was nearly identical. More males (29%) than females (18%) had isolated lateral meniscal tears (P = .72). No significant difference in the relative severity of the tibial contusions was noted (P = .246). The lateral tibial contusion was rated as being more severe than the medial in the majority of females (64%) and males (57%). CONCLUSION: No significant differences were detected between sexes with noncontact ACL injuries for location of tibial or femoral contusions or meniscal tears or for severity of medial versus lateral tibial contusions. The MRI data were not consistent with the valgus collapse mechanism of injury.

Full Text

Duke Authors

Cited Authors

  • Wittstein, J; Vinson, E; Garrett, W

Published Date

  • June 2014

Published In

Volume / Issue

  • 42 / 6

Start / End Page

  • 1401 - 1407

PubMed ID

  • 24668872

Pubmed Central ID

  • 24668872

Electronic International Standard Serial Number (EISSN)

  • 1552-3365

Digital Object Identifier (DOI)

  • 10.1177/0363546514527415

Language

  • eng

Conference Location

  • United States