Clinical Significance of MRI-Based Measurements of Tibial Plateau Widening Width and Joint Fluid Volume During Anterior Cruciate Ligament Injuries Among Patients With Tibial Plateau Fractures.

Abstract

Aim: This study aimed to explore the diagnostic value of magnetic resonance imaging (MRI)-based tibial plateau widening width (TPW) and joint effusion volume during anterior cruciate ligament (ACL) injuries among patients with tibial plateau fractures.

Methods: This retrospective study collected clinical data from 100 patients with tibial plateau fractures admitted between February 2022 and February 2024. The findings from arthroscopy or surgical intervention served used as the "gold standard". Based on the ACL injury, patients were divided into the injury group (62 cases) and the control group (38 cases). General data were compared between the two groups. Furthermore, TPW and joint effusion were assessed using MRI outcomes, and the diagnostic value of these indices in ACL injury was evaluated. Additionally, the diagnostic efficacy of these indices was assessed using the Receiver Operating Characteristic (ROC) curve, Area Under Curve (AUC), sensitivity, and specificity. Moreover, patients were followed-up for three months after surgery, and the relationship between postoperative knee function recovery, TPW, and joint effusion was evaluated.

Results: The injury group demonstrated a significantly higher TPW than the control group (p < 0.001). Similarly, the joint effusion volume was significantly greater in the injury group compared to the control group (p < 0.01). The AUC of TPW was 0.826 (95% confidence interval (CI): 0.745-0.906), with a sensitivity of 66.10% and a specificity of 89.50%. However, the AUC of joint effusion was 0.691 (95% CI: 0.579-0.803), with a sensitivity of 85.50% and a specificity of 52.60%. Furthermore, the AUC of the joint index was 0.864 (95% CI: 0.793-0.936), with a sensitivity of 80.60% and a specificity of 86.80%. Additionally, correlation analysis revealed a negative correlation between TPW (r = -0.355, p < 0.001), joint effusion (r = -0.375, p < 0.001), and postoperative knee function recovery.

Conclusions: MRI-measured TPW and joint effusion volume hold significantly diagnostic value in assessing ACL injuries associated with tibial plateau fractures and correlate with the patient's postoperative knee functional recovery. These metrics may provide clinicians with important diagnostic and prognostic insights and help formulate individualized treatment plans.