Increased Lateral Tibial Plateau Slope Predisposes Male College Football Players to ACL Injury

Abstract

There are conflicting reports regarding the role of bony morphology characteristics such as an increased tibial slope as a risk factor of anterior cruciate ligament (ACL) injury. The purpose of this study was to determine if there is a correlation between bony morphology characteristics and ACL injury risk in male college football players. Ninety male college football players who underwent magnetic resonance imaging (MRI) for a knee injury between 2005 and 2014 were included. Subjects with an ACL injury (ACL injury group) were matched for age, height, weight and BMI to subjects without ACL injury (control group). Several bony morphology characteristics including medial and lateral condyle width, medial and lateral plateau width, notch width, bicondylar width, notch width index, and medial and lateral tibial slope were measured and compared between groups. Conditional logistic regression was used to analyse the data. Significance level was set at p<0.05. According to univariate analysis, a narrower lateral femoral condyle (OR, 0.82; CI, 0.68-0.97), increased medial tibial plateau slope (OR, 0.1.42; CI, 1.85) and increased lateral tibial plateau slope (OR, 1.43; CI, 1.15-1.78) were associated with an increased risk for ACL injury. Multivariate analysis revealed that increased lateral tibial slope (OR, 1.32; CI, 1.03-1.70) was the sole independent risk of ACL injury. A narrower lateral femoral condyle width and an increased medial and lateral tibial slope predispose male college football players to ACL injury. It is suggested to enroll these high-risk subjects in prevention programs to reduce the incidence of injury.