THE NATUREAL HISTORY OF BONE BRUISES IN THE KNEE: 5–8 YEAR CLINICAL AND MRI FOLLOW UP

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Introduction: The natural history of bone bruises of the knee and their clinical significance remains unclear with only a few short term studies in the literature. Aim: This study was designed to try and elucidate the long term outcome of bone bruises of the knee following trauma. Materials and Methods: 60 patients with bone bruises identified in their knees by MRI scans following trauma were included in the study. All patients were reviewed in a research clinic with a minimum 5 year follow up. A detailed history including mechanism of injury, persistent symptoms and functional status was obtained. Clinical examination to identify intra-articular pathology was then undertaken. All patients had a repeat MRI scan of the knee. The relationship between the injury and the bone bruise, the effect of treatment if any and the long term outcome of such lesions was studied. Results: 80% of the patients had a twisting injury with our without a hyperextension of valgus/varus force. 58% of our series had ACL injuries and 68% of the bone bruises were in the medial condyle. 72% of the patients did not return to their pre-accident status and had continuing symptoms although the majority of them did not have signs of clinical instability. There was MRI evidence of lasting sequelae of bone bruises in the majority of patients. Detailed results will be discussed. Conclusions: bone bruises identified on MRI following trauma to the knee are significant lesions with the potential for long term sequelae.

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