Thursday, December 3 | 10:40 a.m.-10:50 a.m. | R3-SSMK10-8 | Room E450A
What's the best way to develop a prognosis for soccer knee injuries? In this Thursday morning presentation, Egyptian researchers will argue that an MRI-developed "instability ecosystem" is better than relying on the injury's anterior cruciate ligament (ACL) grade.
A team led by presenter Sherif El Hanawy, PhD, of Saudi German Health Egypt in Cairo, conducted a study that included 60 professional soccer players with acute knee injury who underwent an MRI exam within seven days of the trauma. Readers reviewed the exams for the following:
· ACL injury grade (ranging from one [mild], two [partial], and three [complete tear]);
· Functional versus structural fiber continuity;
· Pivot-shift bone bruise pattern;
· Lateral femoral notch/depression;
· Meniscocapsular or ramp lesion;
· Meniscal root/radial tear;
· Collateral ligament injury;
· Posterolateral/posteromedial corner injury;
· Chondral/osteochondral injury; and
· Joint effusion/hemarthrosis.
Hanawy and colleagues considered clinical outcomes such as decision to operate, delayed return to play, and symptomatic instability during follow-up; they also developed an AI-based risk framework that combined MRI features into low-, intermediate-, and high-risk categories.
The group reported ACL injury in 63.3% of the 60 players, and that a "multi-structure MRI score" improved clinicians' assessment of the injury (area under the receiver operating curve [AUC], 0.86; sensitivity, 84%; specificity, 78%). The team also found that the prototype AI-assisted framework it developed showed preliminary internal accuracy of 81.7% (AUC = 0.88).
"This framework provides a practical MRI pathway for communicating instability risk, operative likelihood, and rehabilitation complexity to sports medicine teams," Hanawy and colleagues concluded.
