Correlation Between Anterior Cruciate Ligament Injury And The Bone Bruise In The Posterior Of Tibial Plateau

Objective:To explore the risk factors and formation mechanism of the bone bruise in the posterior of tibial plateau.Focusing on the correlation between different degrees of anterior cruciate ligament(ACL)injury and the bone bruise in the posterior of tibial plateau.Methods:A retrospective study of 155 patients who were treated in our hospital with knee plaster fixation,brace fixation,or surgery due to knee trauma from 2017.10 to 2019.11,with 100 males and 55 females,with an average age of 40.0 ± 10.6 years.Sides: 71 cases of right knee injury and 84 cases of left knee injury.The patient’s medical record and knee joint imaging data was retrospective analyzed.According to whether there was bone bruise in the posterior of tibial plateau,the patients were divided into two groups,one group named bone bruise-group which included 92 cases of bone bruise in the posterior of tibial plateau and the other group named non-bone bruise group with 63 patients whoes posterior part of tibial plateau was normal.Possible risk factors included demographic factors(age,gender,side),ACL injury,posteri or cruciate ligament(PCL)injury,medial collateral ligament(MCL)injury,and lateral collateral ligament LCL)injury,fibular head injury and knee injury mechanism.The univariate analysis and binary logistic regression statistical methods were used to investigate the risk factors of bone bruise in the posterior of tibial plateau,and to clarify the relationship between different degrees of ACL injury and bone bruise in the posterior of tibial plateau.Results:1 Univariate analysis of risk factor for bone bruise in the posterior of tibial plateau.There were significant differences in the injury of ACL and fibular head between two groups(P<0.05).There were no significant differences in the gender composition,age,side of injury knee,LCL injury,MCL injury,the mechanism of injury and PCL injury between the two groups(P> 0.05).2 Multivariate analysis of risk factors for bone bruise in the posterior of tibial plateau.The analysis showed that the partial ACL rupture(OR = 2.823,95% CI: 1.268-6.286,P= 0.01),complete ACL rupture(OR = 3.433,95% CI: 1.428-8.253,P= 0.00)and the injury of fibula head(OR = 2.098,95% CI: 1.067-4.125,P= 0.00)are independent risk factors for the bone bruise in the posterior of tibial plateau.Conclusion:1 The injuries of ACL and fibular head are the risk factors of bone bruise in the posterior of tibial plateau;2 Complete ACL rupture is more likely to be combined with the bone bruise in the posterior of tibial plateau than partial ACL rupture;Impact of fibular head and tibial plateau,"pivot shift mechanism" and tibia translation of the knee involve the formation of the bone bruise in the posterior of tibial plateau.3 This study suggests that patients with ACL injury should be reviewed by MRI and high-resolution spiral CT before removing the brace to assess the status of bone bruise and provide a basis for the next treatment measures.