Abstract：
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
目的：系统调查有症状的儿童足球运动员膝关节MRI表现与骨骼成熟度的相关性，并确定手术的预测因素。
方法：本IRB批准，符合HIPAA的回顾性研究包括在过去5年（2018-2023年）接受MRI检查的足球运动员（<18岁）。两名放射科医生回顾性并独立审查了所有检查，以对骨骼成熟度进行分类并确定骨和软组织的发现。比较成熟组之间的结果，和logistic回归模型用于确定手术的预测因素.
结果：97名球员（45名男孩，52个女孩）包括39个骨骼不成熟，21成熟，和37个成熟的膝盖。观察者间可靠性的Kappa系数介于0.65和1.00之间。Osgood-Schlatter病（OSD）在未成熟和成熟的膝盖中更为常见（25％vs14％和5％，p=0.04）；前交叉韧带（ACL）损伤在成熟和成熟的膝盖中比未成熟的膝盖更常见（59％和48％，vs15%，p<0.01）；半月板撕裂在成熟的膝盖中比未成熟和成熟的膝盖更常见（内侧，41%比18%和14%，p=0.03；横向，43%比21%和19%，p=0.04)。成熟组的运动员更有可能接受手术（p=0.01）。存在积液（OR=19.5，95％CI2.8-240.9，p=0.01），ACL损伤（OR=170.0，95%CI1.3-6996.9，p<0.01），和外侧半月板撕裂（OR=10.8，95％CI1.8-106.1，p=0.02）是手术的独立预测因素。
结论：在有症状的儿童足球运动员中发现了不同的损伤模式；存在积液，ACL损伤,外侧半月板撕裂是手术的独立预测因素，可能导致骨骼成熟的球员手术率更高。
方法：本IRB批准，符合HIPAA的回顾性研究包括在过去5年（2018-2023年）接受MRI检查的足球运动员（<18岁）。两名放射科医生回顾性并独立审查了所有检查，以对骨骼成熟度进行分类并确定骨和软组织的发现。比较成熟组之间的结果，和logistic回归模型用于确定手术的预测因素.
结果：97名球员（45名男孩，52个女孩）包括39个骨骼不成熟，21成熟，和37个成熟的膝盖。观察者间可靠性的Kappa系数介于0.65和1.00之间。Osgood-Schlatter病（OSD）在未成熟和成熟的膝盖中更为常见（25％vs14％和5％，p=0.04）；前交叉韧带（ACL）损伤在成熟和成熟的膝盖中比未成熟的膝盖更常见（59％和48％，vs15%，p<0.01）；半月板撕裂在成熟的膝盖中比未成熟和成熟的膝盖更常见（内侧，41%比18%和14%，p=0.03；横向，43%比21%和19%，p=0.04)。成熟组的运动员更有可能接受手术（p=0.01）。存在积液（OR=19.5，95％CI2.8-240.9，p=0.01），ACL损伤（OR=170.0，95%CI1.3-6996.9，p<0.01），和外侧半月板撕裂（OR=10.8，95％CI1.8-106.1，p=0.02）是手术的独立预测因素。
结论：在有症状的儿童足球运动员中发现了不同的损伤模式；存在积液，ACL损伤,外侧半月板撕裂是手术的独立预测因素，可能导致骨骼成熟的球员手术率更高。
