Abstract
BackgroundMany studies have shown that distal femoral sagittal morphological characteristics have a clear relationship with knee joint kinematics. The aim of this study was to determine the relationship between distal femoral sagittal morphological characteristics and noncontact anterior cruciate ligament (ACL) injury.MethodsA retrospective case-control study of 148 patients was conducted. Two age- and sex-matched cohorts (each n = 74) were analysed: a noncontact ACL injury group and a control group. Several characteristics were compared between the two groups, including the lateral femoral posterior radius (LFPR), medial femoral posterior radius (MFPR), lateral height of the distal femur (LH), medial height of the distal femur (MH), lateral femoral anteroposterior diameter (LFAP), medial femoral anteroposterior diameter (MFAP), lateral femoral posterior radius ratio (LFPRR), and medial femoral posterior radius ratio (MFPRR). Receiver operating characteristic (ROC) analysis was used to evaluate the significance of the LFPRR and MFPRR in predicting ACL injury.ResultsCompared with patients in the control group, patients in the ACL injury group had an increased LFPR, MFPR, MFAP, LFPRR, and MFPRR. ROC analysis revealed that an increased LFPRR above 31.7% was associated with noncontact ACL injury, with a sensitivity of 78.4% and a specificity of 58.1%; additionally. an increased MFPRR above 33.4% was associated with noncontact ACL injury, with a sensitivity of 58.1% and a specificity of 70.3%.ConclusionThis study showed that increased LFPRR and increased MFPRR are risk factors for developing noncontact ACL injury. These data could thus help identify individuals susceptible to ACL injuries.
Highlights
Many studies have shown that distal femoral sagittal morphological characteristics have a clear relationship with knee joint kinematics
The measurements of knee osseous morphological characteristics in this study were reliable and reproducible, which is evidenced by the test-retest reliability, with intraclass correlation coefficient (ICC) values ranging from 0.870 to 0.989, both within and between subjects
Receiver operating characteristic (ROC) curve analysis demonstrated that a cut-off of 31.7% (Youden index, 0.365) for the lateral femoral posterior radius ratio (LFPRR) yielded a sensitivity of 78.4% and specificity of 58.1% for predicting noncontact anterior cruciate ligament (ACL) injury, and a cut-off of 33.4%
Summary
Many studies have shown that distal femoral sagittal morphological characteristics have a clear relationship with knee joint kinematics. The aim of this study was to determine the relationship between distal femoral sagittal morphological characteristics and noncontact anterior cruciate ligament (ACL) injury. Fu et al BMC Musculoskeletal Disorders (2022) 23:114 These previous studies did not investigate the osseous morphological characteristics of the lateral and medial condyles separately, and they overlooked the difference between the lateral femoral condyle and medial condyle [13, 14], the presence of which has been confirmed. Most flexion of the knee occurs on the femoral posterior condyles [17,18,19], the area at which most noncontact ACL injuries occur These sagittal osseous morphological characteristics of the distal femoral condyle that are associated with knee joint kinematics might affect the occurrence of noncontact ACL injury. It remains unclear whether the lateral and medial sagittal osseous morphological characteristics of the distal femur are associated with noncontact ACL injury
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