Hakan Ilaslan MD, Presenter: Nothing to Disclose

Naveen Subhas MD, Abstract Co-Author: Nothing to Disclose

Joshua Matthew Polster MD, Abstract Co-Author: Nothing to Disclose

Murali Sundaram MD, Abstract Co-Author: Nothing to Disclose

Jean Pierre Schils MD, Abstract Co-Author: Nothing to Disclose

Carl Scherman Winalski MD, Abstract Co-Author: Institutional research contract, Abbott Laboratories Institutional research contract, Smith & Nephew plc Research Grant, Smith & Nephew plc Institutional research contract, Johnson & Johnson Research Grant, The Procter & Gamble Company Shareholder, NitroSci Pharmaceuticals, LLC Shareholder, Pfizer Inc

ACL injuries often result in osteochondral impaction of lateral femoral condyles anteriorly which is sometimes referred as “deep sulcus”sign. Follow−up MRIs occasionally show chondral defects in this region. We believe depth of osteochondral impaction at the time of initial injury could predict subsequent development of chondral defects.

50 consecutive patients with MRIs within 1 month of ACL tear and follow−up MRIs at least 6 months after the initial injury were included in the study. On the initial examinations, the depth of sulcus was measured in sagittal plane on PD/T2W Images using the standard measuring tool on PACS station. Presence or absence of underlying bone marrow edema and distinct subchondral fracture line were also noted. Follow−up examinations were reviewed for the presence or absence of chondral defects at the site of the impaction injury seen on the prior MRIs.

7 patients had chondral defects on the follow−up examinations in the lateral femoral condyles (14%). In these patients, the depth of sulcus on the initial examinations ranged from 2.3 mm to 2.7 mm (average 2.4 mm). All of these patients had underlying bone marrow edema and 2 had distinct subchondral fractures. 43 patients had no chondral defects on the follow−up examinations. In these patients, the depth of the sulcus ranged from 0 mm to 2 mm (average 1.1 mm) . 16 of these patients had little or no associated bone marrow edema.

The depth of impaction at lateral femoral condyle related to an ACL tear maybe a useful predictor for subsequent development of chondral defects at this location. If the sulcus depth is greater than 2 mm with marked underlying bone marrow edema or subchondral fracture, it is more likely that a chondral defect will develop in the future.  

At the time of ACL tear, the depth of impaction at lateral femoral condyle appears to correlate with subsequent development of chondral defects at this location.

Ilaslan, H, Subhas, N, Polster, J, Sundaram, M, Schils, J, Winalski, C, Lateral Femoral Osteochondral Impaction Following ACL Injuries: Is the Depth of Sulcus Helpful in Prediction of Subsequent Chondral Defects.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12036951.html