3D-Surgery, Department of General-, Traumaand Reconstructive Surgery, University Hospital of Munich (LMU); Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig Maximilian University Munich.
Dtsch Arztebl Int. 2018 Jun 15;115(24):401-408. doi: 10.3238/arztebl.2018.0401.
In many countries around the world, football (association football, or "soccer" predominantly in North America) is the sport most commonly played by children and adolescents. It is widely thought that football players are more likely to develop genu varum (bowlegs); an association with knee arthritis also seems likely. The goals of this systematic review and meta-analysis are to provide an overview of the available evidence on genu varum after intensive soccer training in childhood and adolescence, and to discuss the possible pathogenetic mechanisms.
We systematically searched the PubMed, Medline, Embase, and Coch- rane Library databases for studies of the relation between leg axis development and intensive football playing during the growing years.
Controlled studies employing the intercondylar distance (ICD) as the target variable were evaluated in a meta-analysis, with the mean difference as a measure of effect strength. This meta-analysis included 3 studies with a total of 1344 football players and 1277 control individuals. All three studies individually showed a signifi- cant difference in the mean ICD values of the two groups. The pooled effect esti- mator for the mean difference was 1.50 cm (95% confidence interval [0.53; 2.46]). Two further studies that could not be included in the meta-analysis had similar con- clusions. Asymmetrical, varus muscle forces and predominantly varus stress on the osseous growth plates neighboring the knee joint, especially during the prepubertal growth spurt, seem to be the cause of this phenomenon.
Intensive soccer playing during the growing years can promote the devel- opment of bowlegs (genu varum) and, in turn, increase the risk of knee arthritis. Phy- sicians should inform young athletes and their parents of this if asked to advise about the choice of soccer as a sport for intensive training. It cannot be concluded, however, that football predisposes to bowlegs when played merely as a leisure activity.
在世界上许多国家，足球（主要在北美被称为“soccer”）是儿童和青少年最常参与的运动。人们普遍认为足球运动员更容易出现膝内翻（bowlegs）；而且他们似乎也更容易患膝关节关节炎。本系统评价和荟萃分析的目的是提供关于儿童和青少年时期密集足球训练后膝内翻的现有证据概述，并讨论可能的发病机制。
我们系统地检索了 PubMed、Medline、Embase 和 Cochrane 图书馆数据库，以寻找关于在生长期间腿部轴发育与密集足球运动之间关系的研究。
采用髁间距离（ICD）作为目标变量的对照研究进行了荟萃分析，以均数差作为效应强度的衡量指标。该荟萃分析纳入了 3 项研究，共有 1344 名足球运动员和 1277 名对照个体。这 3 项研究个体均显示两组 ICD 值的均数存在显著差异。均数差的汇总效应估计值为 1.50cm（95%置信区间[0.53；2.46]）。另外两项无法纳入荟萃分析的研究得出了类似的结论。膝关节周围骺板的不对称、内翻肌肉力量和主要的内翻应力，尤其是在青春期生长突增期间，似乎是造成这种现象的原因。
生长期间密集的足球运动可能会导致膝内翻（bowlegs）的发展，进而增加患膝关节关节炎的风险。如果被要求提供关于选择足球作为高强度训练运动的建议，医生应该将这一信息告知年轻运动员及其家长。但是，不能得出足球只是作为休闲活动时就会导致膝内翻的结论。
