Semi-quantitative bone bruise ratios predict high-grade lateral meniscal injury in ACL ruptures with kissing contusion: a multicenter retrospective cohort study

Résumé fourni par la source

Lateral meniscus injury (LMI) is challenging to identify in acute anterior cruciate ligament (ACL) injuries. Kissing contusion, a characteristic MRI feature of ACL injury, suggests potential associations between bone marrow edema, femorotibial morphology, and LMI, though these relationships remain unclear. A retrospective analysis was conducted on 193 patients who were diagnosed with ACL tears accompanied by kissing contusion in four different centers. LMI was confirmed by arthroscopy and was divided into the study group (88 patients) and the control group (105 patients) based on whether partial resection or repair was required. The anterior-posterior width ratio of femoral (FBBR) and tibial (TBBR) bone bruises, lateral femoral condyle ratio (LFCR) and width (LFCW), and lateral tibial plateau width (LTPW) were quantified on magnetic resonance imaging (MRI). The unpaired t-test and pearson correlation analysis were conducted. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic capacity for LMI, and a binary logistic regression model was established. Among the 193 patients, FBBR and TBBR were negatively correlated with LTPW, with r value of -0.27 ( P < 0.001) and − 0.37 ( P < 0.001), respectively. Compared to controls, the study group exhibited significantly higher FBBR (38.8 ± 13.8% vs. 20.3 ± 10.6%, P < 0.001) and TBBR (51.4 ± 32.5% vs. 29.2 ± 17.9%, P < 0.001). Conversely, LFCR, LFCW, and LTPW were significantly lower in the study group ( P < 0.001). ROC analysis demonstrated excellent diagnostic performance of FBBR (AUC 0.875; cutoff 29.2%, sensitivity 79.5%, specificity 87.6%) and modest discriminative ability of TBBR (AUC 0.717, 52.3% sensitivity, 85.7% specificity) for high-grade LMI. Logistic regression identified both FBBR (OR 1.14, 95% CI 1.09–1.18, P < 0.001) and TBBR (OR 1.02, 95% CI 1.00-1.04, P = 0.027) as independent risk factors for LMI. Greater bone bruise severity is associated with specific lateral compartment morphology. FBBR and TBBR may serve as supplementary imaging biomarkers for concomitant high-grade LMI in ACL-injured patients with kissing contusion. Level III, retrospective cohort study.

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