Evaluation of Bone Bruises and Associated Cartilage in Anterior Cruciate Ligament–Injured and –Reconstructed Knees Using Quantitative T1ρ Magnetic Resonance Imaging: 1-Year Cohort Study

Purpose To quantitate bone marrow edema–like lesions (BMELs) and the radiologic properties of cartilage in knees with acute anterior cruciate ligament (ACL) injuries using T 1ρ magnetic resonance imaging over a 1-year period. Methods Nine patients with ACL injuries were studied. Magnetic resonance imaging scans were acquired within 8 weeks of the injury, after which ACL reconstruction surgery was performed. Images were then acquired 0.5, 6, and 12 months after reconstructions. The volume and signal intensity of BMELs were quantified at baseline and follow-up examinations. T 1ρ values were quantified in cartilage overlying the BMEL (OC) and compared with surrounding cartilage at all time points. Results BMELs were most commonly found in the lateral tibia and lateral femoral condyle. Nearly 50% of BMELs resolved over a 1-year period. The T 1ρ values of the OC in the lateral tibia, medial tibia, and medial femoral condyle were elevated compared with respective regions in surrounding cartilage at all time points; the difference was significant only in the lateral tibia ( P 1ρ values of OC in the lateral tibia was significantly correlated with BMEL volume ( r = 0.74, P 1ρ values despite improvement of BMEL. Conclusions In patients after ACL tear and reconstruction, (1) the cartilage overlying BMEL in the lateral tibia experiences persistent T 1ρ signal changes immediately after acute injuries and at 1-year follow-up despite BMEL improvement, (2) the superficial layers of the overlying cartilage show greater matrix damage than the deep layers, and (3) the volume of the BMEL may predict the severity of the overlying matrix's damage in the lateral tibia. T 1ρ is capable of quantitatively and noninvasively monitoring this damage and detecting early cartilage changes in the lateral tibia over time. Level of Evidence Level IV, therapeutic case series.