Kilic Koray Kaya, Yuncu Murat, Dogruoz Fırat, Buyukarslan Volkan, Ertan Mehmet Baris, Kose Ozkan
Department of Radiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey.
Department of Orthopedics and Traumatology, University of Health Sciences, Antalya Training and Research Hospital, Varlık mah., Kazım Karabekir cd, Antalya, 07100, Turkey.
BMC Musculoskelet Disord. 2024 Dec 5;25(1):1001. doi: 10.1186/s12891-024-08119-0.
Calf muscle strain injuries (CMSI), also known as "tennis leg," are frequently observed in middle-aged and physically active people, including non-professional athletes. While magnetic resonance imaging (MRI) is frequently used to assess the extent of these injuries, the relationship between MRI findings and long-term functional outcomes in non-athletic populations remains underexplored. This study aimed to investigate the correlation between MRI-detected injury severity and functional outcomes using the Achilles Tendon Rupture Score (ATRS) and the Tegner Activity Scale (TAS).
A retrospective review was conducted on 78 non-athletic patients diagnosed with CMSI and were followed for an average of 25.6 ± 16.1 months. Injury severity was classified into three grades: Grade 1 (edema without architectural disruption), Grade 2 (partial muscle disruption with hematoma), and Grade 3 (complete muscle disruption or tendon detachment) based on MRI examination. The functional outcomes were assessed using the ATRS and TAS. A simple linear regression analysis was conducted to assess the impact of demographic variables and MRI findings on ATRS.
The mean ATRS at the final follow-up was 92.9 ± 10.6, with 75.6% of patients achieving an excellent outcome. Despite the excellent ATRS scores, a notable reduction in TAS was evident from the pre-injury assessment (4.4 ± 1.2) to the final follow-up (3.8 ± 1.3; p < 0.001). Moreover, 44.9% of patients did not resume their pre-injury activity levels. The regression analysis demonstrated no statistically significant correlation between MRI-detected injury severity, demographic factors (age, gender, BMI), and ATRS outcomes (R² = 0.094, adjusted R² = -0.011).
MRI-detected injury severity does not significantly predict long-term functional outcomes in patients with CMSI, even though most patients achieved excellent ATRS scores. However, nearly half of the patients did not return to their pre-injury activity levels. These findings suggest that additional factors might influence recovery, and further research is needed to elucidate these factors in non-athletic patients.
Level IV, Retrospective case series.
小腿肌肉拉伤（CMSI），也称为“网球腿”，在中年人和体育活动人群中经常出现，包括非职业运动员。虽然磁共振成像（MRI）经常用于评估这些损伤的程度，但在非运动员人群中，MRI表现与长期功能结局之间的关系仍未得到充分研究。本研究旨在使用跟腱断裂评分（ATRS）和特格纳活动量表（TAS）来调查MRI检测到的损伤严重程度与功能结局之间的相关性。
对78例诊断为CMSI的非运动员患者进行回顾性研究，平均随访25.6±16.1个月。根据MRI检查，损伤严重程度分为三个等级：1级（无结构破坏的水肿）、2级（伴有血肿的部分肌肉断裂）和3级（完全肌肉断裂或肌腱附着处分离）。使用ATRS和TAS评估功能结局。进行简单线性回归分析，以评估人口统计学变量和MRI表现对ATRS的影响。
末次随访时的平均ATRS为92.9±10.6，75.6%的患者获得了优异的结局。尽管ATRS评分优异，但从损伤前评估（4.4±1.2）到末次随访（3.8±1.3；p<0.001），TAS明显下降。此外，44.9%的患者未恢复到损伤前的活动水平。回归分析表明，MRI检测到的损伤严重程度、人口统计学因素（年龄、性别、体重指数）与ATRS结局之间无统计学显著相关性（R² = 0.094，调整后R² = -0.011）。
尽管大多数患者的ATRS评分优异，但MRI检测到的损伤严重程度并不能显著预测CMSI患者的长期功能结局。然而，近一半的患者未恢复到损伤前的活动水平。这些发现表明，可能有其他因素影响恢复，需要进一步研究以阐明非运动员患者中的这些因素。
IV级，回顾性病例系列。
