A radiographic zone-based approach to predict meniscus injury in lateral tibial plateau fracture

Salari, Pooria; Busel, Gennadiy; Watson, John T.

doi:10.1016/j.injury.2020.10.022

Cited by 12 publications

(13 citation statements)

References 10 publications

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“…In spite of this, the emerging evidence suggested a lower incidence of meniscus injury requiring surgical intervention than previously demonstrated according to MRI images before surgery [13]. Recently, Salari et al [10] described that CT measurement of fracture location and articular impaction/displacement in tibial plateau fractures can be used to predict lateral meniscus injury with a high accuracy. With the further expansion of the sample size, the rational use of CT image analysis will provide a more accurate clinical reference for the in-depth study on the relationship between the location and pattern of meniscus injury and the morphology of tibial plateau fractures in different types.…”

Section: Discussionmentioning

confidence: 99%

“…According to the Chinese experts' consensus on the diagnosis and treatment of tibial plateau fractures published in 2015, there is a great deal of controversy on whether routine MRI examination is needed for fresh fractures while the vast majority of patients with tibial plateau fractures receive preoperative X-ray and CT examinations. In recent years, some clinical studies have pointed out that preoperative knee X-ray and CT examination can also indicate tibial plateau fracture combined with soft tissue injury, especially meniscus injury [5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Correlation Between CT Images of Lateral Plateau and Lateral Meniscus Injuries in Patients With Schatzker II Tibial Plateau Fractures：A Retrospective Study

Ying¹,

Zhu²,

Ding³

et al. 2021

Preprint

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Background: There is a great deal of controversy on whether routine MRI examination is needed for fresh fractures while the vast majority of patients with tibial plateau fractures receive preoperative X-ray and CT examinations. The purpose of the study was to analyze the exact correlation between CT images of lateral plateau and lateral meniscus injuries in Schatzker II tibial plateau fractures. Methods: Two hundred and ninety-six Schatzker II tibial plateau fracture patients from August 2012 to January 2021 in two trauma centers were enrolled for the analysis. According to the actual situation during open reduction internal fixation (ORIF) and knee arthroscopic surgery, patients were divided into meniscus injury (including rupture, incarceration, etc.) and non-meniscus injury groups. By measuring the value of both lateral plateau depression (LPD) and lateral plateau widening (LPW) of lateral tibial plateau on the coronary CT images, the correlation of which and lateral meniscus injury was analyzed. Meanwhile, the relevant receiver operating characteristic (ROC) curve was drawn to evaluate the optimal operating point of these two indicators which could predict meniscus injury. Results: Meniscus injury group mainly showed injuries involving the mid-body and posterior horn of the meniscus (98.1%, 157/160). The average LPD was 13.2 ± 3.2 mm, while the average value of the group without meniscus injury was 9.4 ± 3.2 mm. The difference was statistically significant (P < 0.05). The average LPW was 8.0 ± 1.4 mm and 6.8 ± 1.6 mm in two groups with a significant difference (P < 0.05). The optimal operating point of LPD and LPW was 7.9 mm (sensitivity-95.0%, specificity-58.8%, area under the curve (AUC-0.818) and 7.5 mm (sensitivity-70.0%, specificity-70.6%, AUC-0.724), respectively. Conclusions: The mid-body and posterior horn of lateral meniscus injury is more likely to occur in patients who had Schatzker II tibial plateau fractures when LPD > 7.9 mm and/or LPW > 7.5 mm on CT manifestations and these findings will definitely provide guidance for orthopedic surgeons in treating such injuries. During the operation, more attention should be paid to the treatment of the meniscus and full consideration is needed be taken to situations such as meniscus rupture, incarceration and other possible fracture reduction difficulties, poor vertical line, etc., in order to achieve better surgical results.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Correlation Between CT Images of Lateral Plateau and Lateral Meniscus Injuries in Patients With Schatzker II Tibial Plateau Fractures：A Retrospective Study

Ying¹,

Zhu²,

Ding³

et al. 2021

Preprint

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“…It has been suggested by a recent study that lateral TPFs with articular impaction ≥ 4.3 mm on CT mean inevitably meniscus tear, as the risk of meniscus injury increased by 21% when articular displacement increased 1 mm, especially in the anterior region by four zone methods[ 8 ]. The result was also confirmed by other researches[ 7 , 13 , 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Minimally invasive surgery and accelerated enhanced recovery after surgery lead to an increasing number of arthroscopic managements for TPFs[ 6 ]. There is medical literature that suggests CT shows a relationship between the occurrence of lateral meniscal lesions and the state of fracture depression in the lateral TPFs (85 cases)[ 7 , 8 ]. Recently, it has been reported that arthroscopic meniscal lesions contain degenerative tears with partial fracture parameters on CT, according to the degree of fracture severity[ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Is traumatic meniscal lesion associated with acute fracture morphology changes of tibia plateau? A series of arthroscopic analysis of 67 patients

Chen¹,

Chen²,

Liu³

et al. 2021

WJCC

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“…Worse still, it will cause unnecessary economic losses and psychological pressure. According to related studies, tibial plateau fractures combined with meniscus injuries have become increasingly common, with the incidence ranging from 47% to 99% [4].…”

Section: Introductionmentioning

confidence: 99%

Deep Learning-Based MRI in Diagnosis of Fracture of Tibial Plateau Combined with Meniscus Injury

Xie

Bai

et al. 2021

Scientific Programming

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This study aimed to explore the application value of magnetic resonance imaging (MRI) images based on deep learning algorithms in the diagnosis of tibial plateau fractures combined with meniscus injuries. The original MRI image was input into the deep learning convolutional neural network (CNN), and the knee joint undersampled and fully sampled MRI image data were used for training to obtain a neural network model that can effectively remove the noise and blur of the undersampled image. Then, the image was reconstructed by the Regridding model to obtain an image with less noise and clearer structure. At the same time, all subjects underwent knee MRI examinations, and algorithms were used to analyze the sensitivity, specificity, and accuracy of their images. It was found that of 160 menisci from 80 cases of tibial plateau fractures, 64 were normal meniscus and 88 were injured menisci. The sensitivity, specificity, and accuracy of optimized MRI in diagnosing fracture of tibial plateau combined with meniscus injury were 96.9%, 93.2%, and 95.3%, respectively. In conclusion, the restored MRI images have high sensitivity in the diagnosis of meniscus injury and high consistency with the intraoperative results. It suggests that the optimized MRI image is effective in the diagnosis of meniscus injury.

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A radiographic zone-based approach to predict meniscus injury in lateral tibial plateau fracture

Cited by 12 publications

References 10 publications

Correlation Between CT Images of Lateral Plateau and Lateral Meniscus Injuries in Patients With Schatzker II Tibial Plateau Fractures：A Retrospective Study

Correlation Between CT Images of Lateral Plateau and Lateral Meniscus Injuries in Patients With Schatzker II Tibial Plateau Fractures：A Retrospective Study

Is traumatic meniscal lesion associated with acute fracture morphology changes of tibia plateau? A series of arthroscopic analysis of 67 patients

Deep Learning-Based MRI in Diagnosis of Fracture of Tibial Plateau Combined with Meniscus Injury

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