Oslo Sports Trauma Research Center

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Information about project titled 'New MRI muscle classification systems and associations with return to sport after acute hamstring injuries - a prospective study'

New MRI muscle classification systems and associations with return to sport after acute hamstring injuries - a prospective study

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Project status: Published
Project manager: Arnlaug Wangensteen
Supervisor(s): Johannes Tol, Roald Bahr
Coworker(s): Ali Guermazi, Frank W. Roemer, Bruce Hamilton, Juan-Manuel Alonso, Rodney Whitely

Description

Background: New MRI grading and classification systems have not been prospectively investigated for their agreement and prognostic value after acute hamstring injuries.

Aims: To determine agreement between modified Peetrons, Chan acute muscle strain injury classification and British Athletics Muscle Injury Classification (BAMIC) and to investigate their associations and ability to predict time to return to sport (RTS).

Methods: Male athletes (n=176) with acute hamstring injury and MRI (1.5T) ≤5 days were followed until RTS. MRIs were scored using standardised forms.

Results: For MRI-positive injuries there was moderate agreement between the severity gradings (O.50-0.56). Substantial variance in RTS within and between the MRI categories was demonstrated. Mean differences showed overall main effect for severity gradings (p<0.001), but post-hoc pairwise-comparisons for BAMIC (grade 0a/b vs. 1, p=0.312; 1 vs. 2, p=0.054; 0a/b vs. 2, p<0.001; 1 vs 3, p<0.001) and mean differences for anatomical sites (BAMIC a-c, p<0.001 (a vs. b, p=0.974; a vs. c, p=0.065; b vs. c, p=0.007); Chan anatomical sites 1-5, p<0.077; 2.A-C, p=0.373; 2.a-e, p=0.008; combined BAMIC, p<0.001) varied. For MRI-positive injuries, the total variance in RTS explained ranged from 7.6%-11.9% for severity gradings and BAMIC anatomical site.

Conclusions: There was a wide overlap between and variation within the grading-and classification categories. Therefore, none of the classification systems could be used to predict RTS in our sample of MRI-positive hamstring injuries.