Femoral anteversion as a potential risk factor for anterior cruciate ligament injuries in athletes

IF 2 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2024-12-31 DOI:10.1002/jeo2.70133

Alireza Mirahmadi, Pooya Hosseini-Monfared, Maryam Salimi, Arya Kazemi, Naser Ghanbari, Vahid Shameli, Seyed Morteza Kazemi

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Abstract

Purpose

Non-contact anterior cruciate ligament (ACL) injuries are influenced by the anatomic and biomechanical characteristics of the lower limb. The combination of knee valgus, hip internal rotation and tibial external rotation are important contributors to non-contact ACL injuries. In this study, we aimed to evaluate the effect of femoral anteversion on the incidence of ACL injuries among athletes.

Methods

A retrospective comparative study was conducted on 137 adult male athletes with high suspicion of ACL injury following a sports-related injury. The patients were classified into two groups based on the presence of ACL tears: the ‘ACL tear’ and the ‘ACL intact’ groups. The femoral anteversion angle was measured by both a computed tomography (CT) scan using the method described by Hernandez et al. and a physical examination using Craig's test. The association of ACL tears with femoral anteversion angle was evaluated. Femoral anteversion cut-off values were calculated to find the best margin for a high probability of ACL tearing.

Results

The mean anteversion in patients with ACL tears was found to be higher compared to ACL-intact patients both in CT scan measures (18.4 ± 5.5 vs. 12.9 ± 6.9, p value < 0.001) and physical examination (20.2 ± 5.9 vs. 14.8 ± 7.7, p value < 0.001). The correlation analysis revealed an excellent correlation between femoral anteversion measured by CT scan and Craig's test results (r = 0.94). Cut-off values for femoral anteversion measured by CT scan concerning ACL tearing with the highest sensitivity and specificity were 12.7 and 19.0, respectively. The Craig-measured cut-off values were 1.5–2° more than the CT scan measurements.

Conclusion

This study reveals a significant correlation between increased femoral anteversion and a higher risk of ACL injury among male athletes. The results of this study aid in designing personalized prevention programmes for non-contact ACL injuries among athletes.

Level of Evidence

Level III.

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股骨前倾是运动员前交叉韧带损伤的潜在危险因素。

目的：非接触性前交叉韧带（ACL）损伤受下肢解剖和生物力学特性的影响。膝关节外翻、髋关节内旋和胫骨外旋是造成非接触性前交叉韧带损伤的重要因素。在这项研究中，我们旨在评估股骨前倾对运动员前交叉韧带损伤发生率的影响。方法：对137例运动相关损伤后高度怀疑ACL损伤的成年男性运动员进行回顾性比较研究。患者根据是否存在ACL撕裂分为两组：“ACL撕裂”组和“ACL完整”组。采用Hernandez等人描述的方法通过计算机断层扫描（CT）测量股骨前倾角，并采用Craig试验进行体格检查。评估前交叉韧带撕裂与股前倾角的关系。计算股骨前倾截止值，以找到高概率ACL撕裂的最佳边缘。结果：ACL撕裂患者的平均前倾在CT扫描测量中均高于ACL完整患者（18.4±5.5比12.9±6.9，p值p值r = 0.94）。CT扫描股骨前倾对前交叉韧带撕裂的敏感度和特异度最高的临界值分别为12.7和19.0。克雷格测量的截止值比CT扫描测量值大1.5-2°。结论：本研究揭示了男性运动员股骨前倾增加与前交叉韧带损伤风险增加之间的显著相关性。本研究的结果有助于设计运动员非接触性前交叉韧带损伤的个性化预防方案。证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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