Kaarre Janina, Ahrendt Gillian, Giusto Joseph D, Özbek Emre Anıl, Apseloff Nicholas A, Musahl Volker
Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Acta Orthop Traumatol Turc. 2024 Apr 26;58(2):83-88. doi: 10.5152/j.aott.2024.24005.
The exploration of underlying biological risk factors for anterior cruciate ligament (ACL) injury has generated a substantial body of literature describing the role of bony morphology of the knee. Morphological risk factors, such as poor tibiofemoral joint congruity, a narrow femoral intercondylar notch, and an increased posterior tibial slope (PTS), have been implicated in contributing to knee instability and biomechanical abnormalities. Additionally, investigations into sex-specific differences in bony morphology have unveiled distinct risk profiles for males and females. In light of these findings, surgical considerations for individuals with high-risk bony morphology have been developed. Procedures like anterior closing wedge high tibial osteotomy, aiming to address increased PTS, and lateral extra-articular tenodesis for patients with specific risk factors, have been established. The aim of this review is to provide an overview of the current evidence describing the relationship between bony morphology and ACL injury. Moreover, this review aims to discuss the surgical management and outcomes concerning patients exhibiting high-risk anatomic features.
对前交叉韧带（ACL）损伤潜在生物学危险因素的探索已产生了大量描述膝关节骨形态学作用的文献。形态学危险因素，如胫股关节匹配性差、股骨髁间窝狭窄以及胫骨后倾坡度（PTS）增加，被认为与膝关节不稳定和生物力学异常有关。此外，对骨形态学性别差异的研究揭示了男性和女性不同的风险特征。鉴于这些发现，已针对具有高风险骨形态的个体制定了手术考量。诸如旨在解决PTS增加问题的前闭合楔形高位胫骨截骨术，以及针对具有特定危险因素患者的外侧关节外肌腱固定术等手术方法已确立。本综述的目的是概述描述骨形态与ACL损伤之间关系的当前证据。此外，本综述旨在讨论针对表现出高风险解剖特征患者的手术管理及结果。
