What is the healing time for a focal bone contusion of the posterior lateral tibial (tibia) plateau?

From the Guidelines

A focal bone contusion on the posterolateral tibial plateau typically takes 6 to 12 weeks to heal completely, though this timeline can vary based on the severity of the injury and individual factors. The healing process involves several stages, including initial management with rest, ice, compression, and elevation (RICE protocol) for the first 48-72 hours, followed by protected weight-bearing using crutches or a knee brace for 2-4 weeks as tolerated 1.

Some key considerations for the healing process include:

• Pain management with over-the-counter medications like acetaminophen (500-1000mg every 6 hours as needed) or NSAIDs such as ibuprofen (400-600mg three times daily with food) for the first 1-2 weeks
• Physical therapy starting once acute pain subsides, usually around 2-3 weeks post-injury, focusing first on gentle range of motion exercises and progressing to strengthening and proprioception training
• Gradual return to sports or high-impact activities, typically occurring between 3-4 months post-injury, once full strength, range of motion, and functional capacity have returned
• MRI follow-up may be recommended at 6-8 weeks to confirm healing progress in more severe cases

It's also important to note that the rate of progression should be individualized based on risk and grade of the tibial BSI, as well as the level of the athlete 1. Females may benefit from a slower progression of running due to higher tibial bone stresses across a range of running speeds, compared with males 1.

In terms of returning to running, a walk-run progression on alternate days is recommended, with the initial introduction of running-related loads achieved through the progressive application of load to promote tissue adaptation, whilst preventing injury recurrence 1. The specific length of running increments varied considerably among reviewed studies, however, starting with 30- to 60-s increments, and progressing by 1–2 min, or equivalent distance was suggested by half of the studies 1.

Overall, the healing time for a focal bone contusion on the posterolateral tibial plateau can vary, but with proper management and gradual progression, most individuals can expect to return to full activity within 3-4 months.

From the Research

Healing Time for Focal Bone Contusion of the Posterior Lateral Tibial Plateau

There are no direct research papers that provide a specific healing time for a focal bone contusion of the posterior lateral tibial plateau. However, some studies provide information on the healing time for tibial plateau fractures and bone contusions in general.

• The healing time for tibial plateau fractures can vary depending on the severity of the fracture and the treatment approach. A study by 2 found that patients who underwent early weight-bearing protocols after operative treatment of tibial plateau fractures had similar outcomes and complications compared to those who started weight-bearing after 10 weeks or more.
• Bone contusions are common in patients with anterior cruciate ligament (ACL) ruptures, and the prevalence of bone contusions can increase with the progression of the injury 3.
• A study by 4 found that articular cartilage injury of the posterior lateral tibial plateau is associated with acute ACL injury, and that bone bruises depicted on MRI can be correlated with cartilage injury detected at arthroscopic ACL reconstruction.
• The study by 5 provides information on the treatment and outcomes of patients with isolated posterior coronal fractures of the lateral tibial plateau, but does not specifically address the healing time for focal bone contusions.
• The study by 6 provides a general overview of tibial plateau fractures, including their anatomy, diagnosis, and management, but does not provide specific information on the healing time for focal bone contusions.

Some key points to consider include:

• The healing time for tibial plateau fractures can vary depending on the severity of the fracture and the treatment approach.
• Bone contusions are common in patients with ACL ruptures, and the prevalence of bone contusions can increase with the progression of the injury.
• Articular cartilage injury of the posterior lateral tibial plateau is associated with acute ACL injury, and bone bruises depicted on MRI can be correlated with cartilage injury detected at arthroscopic ACL reconstruction.