Maturation-dependent patterns of knee injuries among symptomatic pediatric soccer players on MRI

Skeletal Radiology - Trang 1-12 - 2023
Vandan Patel1,2,3, Jude Barakat1,4, Lewis Fanney1,5, Liya Gendler1,6, Naomi J. Brown6,3, Theodore J. Ganley6,3, Jie C. Nguyen1,6
1Department of Radiology, Section of MSK, Children’s Hospital of Philadelphia, Philadelphia, USA
2Drexel University College of Medicine, Philadelphia, USA
3Division of Orthopaedic Surgery, Children’s Hospital of Philadelphia, Philadelphia, USA
4University of Pennsylvania School of Engineering and Applied Sciences, Philadelphia, USA
5Eastern Virginia Medical School, Norfolk, USA
6Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA

Tóm tắt

To systematically investigate the prevalence of knee MRI findings among symptomatic pediatric soccer players with respect to skeletal maturity and to identify predictors of surgery. This IRB-approved, HIPAA-compliant retrospective study included soccer players (< 18 years of age) who underwent MRI examinations in the past 5 years (2018–2023). Two radiologists retrospectively and independently reviewed all examinations to categorize skeletal maturity and to identify osseous and soft tissue findings. Findings were compared between maturation groups, and logistic regression models were used to identify predictors of surgery. Ninety-seven players (45 boys, 52 girls) included 39 skeletally immature, 21 maturing, and 37 mature knees. Kappa coefficient for interobserver reliability ranged between 0.65 and 1.00. Osgood-Schlatter disease (OSD) was more common among immature than maturing and mature knees (25% vs 14% and 5%, p = 0.04); anterior cruciate ligament (ACL) injury was more common among maturing and mature than immature knees (59% and 48%, vs 15%, p < 0.01); and meniscal tears were more common among mature than immature and maturing knees (medial, 41% vs 18% and 14%, p = 0.03; lateral, 43% vs 21% and 19%, p = 0.04). Players in the mature group were more likely to undergo surgery (p = 0.01). The presence of an effusion (OR = 19.5, 95% CI 2.8–240.9, p = 0.01), ACL injury (OR = 170.0, 95% CI 1.3–6996.9, p < 0.01), and lateral meniscal tears (OR = 10.8, 95% CI 1.8–106.1, p = 0.02) were independent predictors of surgery. Differential patterns of injury were found among symptomatic pediatric soccer players; the presence of an effusion, ACL injury, and lateral meniscal tears were independent predictors of surgery, likely contributing to the higher rates of surgery among skeletally mature players.

Tài liệu tham khảo

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