Department of Orthopedic Surgery, University Medical Centre Maribor, Maribor, Slovenia.
Department of Orthopedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Arch Orthop Trauma Surg. 2019 Dec;139(12):1771-1777. doi: 10.1007/s00402-019-03266-9. Epub 2019 Aug 28.
To radiographically analyze lower limb alignment in adult asymptomatic professional football players and to correlate these values to clinical measurements.
Twenty-four asymptomatic players [24.2 (3.6) years] were enrolled. Standard bilateral lower limb anteroposterior weight-bearing radiographs were acquired and clinical measurement of intercondylar/intermalleolar (ICD/IMD) distance was performed. Coronal plane mechanical alignment was assessed by five angles: leg mechanical axis (LMA), lateral proximal femoral angle (LPFA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and lateral distal tibial angle (LDTA). Their values were compared to the reference values for adult population. An inter-individual comparison between right/left and dominant/non-dominant leg was added. The sum of bilateral LMA was correlated against ICD/IMD and against ICD/IMD adjusted for body height.
Football players presented with ICD/IMD of 46.5 (19.8) mm. Two, out of five, lower leg coronal angles showed significant differences (p < 0.001) compared to reference data from literature: LMA 5.8 (3.0)º vs.1.2 (2.2)º and MPTA 83.5 (2.6)º vs. 87.2 (1.5)º. No significant differences between left/right leg and dominant/non-dominant leg were established. Summed up bilateral LMA showed a high correlation to IMD/ICD (r = 0.8395; R = 0.7048), and even higher to ICD/IMD adjusted for body height (r = 0.8543; R = 0.7298).
This study was radiographically confirming increased varus of elite football players toward general population. Apex of the varus deformity was located in the proximal tibia. Clinical measurement of ICD/IMD adjusted for body height highly correlated with the radiographic values of coronal alignment; therefore, it may be used in population studies.
本研究旨在对无症状成年职业足球运动员下肢对线进行影像学分析，并将这些数据与临床测量值相关联。
本研究共纳入 24 名无症状足球运动员（24.2±3.6 岁）。所有患者均进行双侧下肢负重正位前后位 X 线片检查，并进行髁间/踝间（ICD/IMD）距离的临床测量。冠状面力学对线通过 5 个角度进行评估：下肢机械轴（LMA）、外侧股骨近端角（LPFA）、外侧股骨远端角（LDFA）、内侧胫骨近端角（MPTA）和外侧胫骨远端角（LDTA）。并将这些值与成人参考值进行比较。同时还对左右侧和优势/非优势侧进行了个体间比较。双侧 LMA 的总和与 ICD/IMD 和经身高调整的 ICD/IMD 进行了相关性分析。
足球运动员的 ICD/IMD 为 46.5±19.8mm。5 个小腿冠状面角度中有 2 个与文献中的参考数据存在显著差异（p＜0.001）：LMA 为 5.8±3.0º 对 1.2±2.2º 和 MPTA 为 83.5±2.6º 对 87.2±1.5º。左右侧和优势/非优势侧之间未发现显著差异。双侧 LMA 总和与 IMD/ICD 呈高度相关（r=0.8395；R²=0.7048），与经身高调整的 ICD/IMD 相关性更高（r=0.8543；R²=0.7298）。
本研究从影像学角度证实，精英足球运动员下肢对线存在向普通人群靠拢的趋势。内翻畸形的顶点位于胫骨近端。经身高调整的 ICD/IMD 临床测量与冠状面对线的影像学值高度相关，因此，它可能用于人群研究。
