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Correlation of Magnetic Resonance Imaging Findings with the Chronicity of an Anterior Cruciate Ligament Tear
Jong Pil Yoon, MD1; Chong Bum Chang, MD, PhD1; Jae Ho Yoo, MD, PhD2; Sung Ju Kim, MS3; Ja Young Choi, MD4; Jung-Ah Choi, MD, PhD1; Sang Cheol Seong, MD, PhD4; Tae Kyun Kim, MD, PhD1
1 Joint Reconstruction Center (J.P.Y., C.B.C., and T.K.K.) and the Department of Radiology (J.-A.C.), Seoul National University Bundang Hospital, 300 Gumidong, Bundangu, Seongnam-si, Gyunggido 463-707, South Korea. E-mail address for T.K. Kim: osktk@snubh.org
2 Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Bucheon, 1174 Jung-dong, Wonmi-gu, Bucheon-si, Gyeonggi-do 420-767, South Korea
3 Department of Statistics, Korea University, Anam-dong, Seongbuk-gu, Seoul 136-701, South Korea
4 Departments of Radiology (J.Y.C.) and Orthopaedic Surgery (S.C.S.), Seoul National University Hospital, 28 Yongondong Chongnogu, Seoul 110-774, South Korea
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at the Joint Reconstruction Center, Seoul National University Bundang Hospital, Seongnam, South Korea

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Feb 01;92(2):353-360. doi: 10.2106/JBJS.I.00031
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Although several findings on magnetic resonance imaging have been demonstrated after anterior cruciate ligament injury, sequential changes on magnetic resonance imaging have not been comprehensively studied. We undertook to correlate four specific findings on magnetic resonance imaging of an anterior cruciate ligament injury over time.


One hundred and forty-five patients with a complete tear of the anterior cruciate ligament confirmed by arthroscopy were divided, according to the time from the injury to the acquisition of the magnetic resonance image, into four groups: acute (within six weeks), subacute (more than six weeks to three months), intermediate (more than three months to one year), and chronic (more than one year). Four findings (anterior cruciate ligament morphology, joint effusion, posterior cruciate ligament angle, and bone bruise) were evaluated for each study group.


Strong correlations were found between the magnetic resonance imaging findings and the chronicity of the anterior cruciate ligament tear. Anterior cruciate morphology showed sequential changes with time (p < 0.001). Joint effusion decreased with time, with a significant difference occurring between the acute and subacute groups at six weeks (p < 0.001). The posterior cruciate ligament angle decreased gradually over time (p < 0.001). Finally, the signal contrast of bone-bruising decreased with time, with a significant change occurring after three months (p = 0.049).


Our study confirmed that these four magnetic resonance imaging variables are closely correlated with the chronicity of an anterior cruciate ligament tear, and estimation of the chronicity of the tear can be facilitated by an integrative interpretation of these findings.

Level of Evidence: 

Diagnostic Level II. See Instructions to Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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