The frequency of hill sachs lesion-like bone marrow edema pattern in anterior cruciate ligament injuries in adults and its relationship with concomitant injuries

Aim: In our study, the aim is to examine the locations of bone marrow edema (BME) in patients diagnosed with acute full-thickness anterior cruciate ligament (ACL) tears and to demonstrate the frequency of patterns resembling an anterior shoulder dislocation mechanism (Hill-Sachs-like). Additionally, the study will investigate the relationships of BME findings with other parameters, the frequency of accompanying other injuries, and the relationships between meniscus injuries and the locations/patterns of BME and other parameters. Materials and Methods: Patients with acute full-thickness ACL tears identified on magnetic resonance imaging (MRI) were included in the study. The locations of BME and the frequencies of Hill-Sachs-like patterns were investigated. Accompanying ligament, meniscus, bone/cartilage injuries were examined. The relationships between accompanying meniscus injuries and BME locations/patterns, morphometric measurements, age, and gender were evaluated. Results: A total of 68 patients were included in the study. The most common regions of edema were the posterolateral tibial plateau (PL, 70.6%), the posteromedial tibial plateau (PM, 51.5%), and the central region of the lateral femoral condyle (LFO, 51.5%). Hill-Sachs-like patterns were observed in 32.35%-50.00% of cases. Medial meniscus tears (MMTs) were found to be less frequent in patients with PL edema (p<0.01) and in those with LFO + PL pattern edema (p=0.046). Patients with MMTs had a lower medial tibial slope (MTS) (p=0.04) and higher lateral tibial height (LTH) (p=0.01), while patients with lateral meniscus tears (LMTs) had a higher MTS (p=0.03). Patients with Hill-Sachs-like edema patterns had lower LTH compared to those without these patterns (p=0.03). Females had a lower medial tibial depth (MTD) compared to males (p<0.01). Conclusion: Our results indicate that Hill-Sachs-like BME patterns are frequently observed following ACL tears in adults. MMTs were less frequently seen in cases with BME in the posterolateral tibial plateau and in Hill-Sachs-like patterns. MTS was associated with both MMTs and LMTs, LTH was associated with both MMTs and BME patterns, and MTD was related to gender. Keywords: Bone marrow, shoulder dislocation, edema, anterior cruciate ligament