股骨前倾作为运动员前交叉韧带损伤的一个潜在风险因素。
Femoral anteversion as a potential risk factor for anterior cruciate ligament injuries in athletes.
作者信息
Mirahmadi Alireza, Hosseini-Monfared Pooya, Salimi Maryam, Kazemi Arya, Ghanbari Naser, Shameli Vahid, Kazemi Seyed Morteza
机构信息
Bone Joint and Related Tissues Research Centre Shahid Beheshti University of Medical Sciences Tehran Iran.
Department of Orthopaedic Surgery Denver Health Medical Centre Denver Colorado USA.
出版信息
J Exp Orthop. 2024 Dec 31;12(1):e70133. doi: 10.1002/jeo2.70133. eCollection 2025 Jan.
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, value < 0.001) and physical examination (20.2 ± 5.9 vs. 14.8 ± 7.7, value < 0.001). The correlation analysis revealed an excellent correlation between femoral anteversion measured by CT scan and Craig's test results ( = 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.
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征的影响。膝外翻、髋内旋和胫骨外旋的组合是非接触性ACL损伤的重要促成因素。在本研究中，我们旨在评估股骨前倾对运动员ACL损伤发生率的影响。
方法
对137名在运动相关损伤后高度怀疑ACL损伤的成年男性运动员进行了一项回顾性对照研究。根据ACL撕裂情况将患者分为两组：“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）测量股骨前倾角度，并使用克雷格试验进行体格检查。评估ACL撕裂与股骨前倾角度之间的关联。计算股骨前倾临界值，以找出ACL撕裂高概率的最佳界限。
结果
在CT扫描测量中（18.4±5.5 vs. 12.9±6.9，P值<0.001）和体格检查中（20.2±5.9 vs. 14.8±7.7，P值<0.001），发现ACL撕裂患者的平均前倾角度均高于ACL完整患者。相关性分析显示，CT扫描测量的股骨前倾与克雷格试验结果之间具有极好的相关性（r = 0.94）。CT扫描测量的与ACL撕裂相关的股骨前倾临界值，灵敏度和特异性最高的分别为12.7和19.0。克雷格测量的临界值比CT扫描测量值高1.5 - 2°。
结论
本研究揭示了股骨前倾增加与男性运动员ACL损伤风险较高之间存在显著相关性。本研究结果有助于为运动员非接触性ACL损伤设计个性化预防方案。
证据级别
三级。
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