Magnetic Resonance Imaging and Intra-articular Findings After Anterior Cruciate Ligament Injuries in Ice Hockey Versus Other Sports

Background: The prevalence of comorbid knee pathology has been examined for sports-related anterior cruciate ligament (ACL) injuries, but it has not been examined in ice hockey players. Purpose: To compare concomitant bone bruising, collateral ligament injuries, and intra-articular injuries in ACL injuries suffered during ice hockey versus other sports. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 20 patients with ACL injuries sustained during ice hockey were identified from a prospective registry, of which 95% were male and 90% had a contact mechanism of injury (MOI). Thirteen cases and 46 controls who sustained ACL injuries from ice hockey and other sports, respectively, were included. Inclusion criteria for cases and controls were male sex, contact MOI, no prior knee surgery, magnetic resonance imaging (MRI) within 6 weeks of injury, and surgery within 3 months of injury. Age, body mass index (BMI), MRI findings (bone bruising, medial and lateral collateral ligament [MCL, LCL] injuries), and arthroscopic findings (meniscus tears, chondral injuries) were compared for cases versus controls using t tests or exact chi-square tests. Results: Age (22.9 ± 8.8 vs 23.4 ± 10.4 years, P =.88) and BMI ≥25 kg/m² (50% vs 65.9%, P =.66) did not differ between cases and controls. Cases had less lateral bone bruising (lateral femoral condyle: 54.6% vs 93%, P =.01; lateral tibial plateau: 72.7% vs 93%, P =.09) and no medial bone bruising (medial femoral condyle: 0% vs 7%, P =.06; medial tibial plateau: 0% vs 32.6%, P =.05) compared with controls. Cases had less frequent lateral meniscus tears than controls (23.1% vs 58.5%, P =.05). There were no significant differences in MCL (40% vs 31.2%, P =.77), LCL (0% vs 3.9%, P >.999), medial meniscus tears (7.7% vs 37%, P =.08), and chondral injuries (10% vs 9.4%, P >.999) for cases versus controls. Conclusion: Male ice hockey players with ACL injuries had less lateral femoral condyle and medial tibial plateau bone bruising compared with other sports injuries. They also had fewer lateral meniscus tears, and there was a trend toward fewer medial meniscus tears. These differences may reflect different MOIs, or the ability to dissipate energy, for contact ACL injuries that occur during ice hockey versus other sports.