Abstract
Anterior knee laxity (AKL) varies widely among individuals, and on average is greater in females than males. Sex hormones may in part explain these differences, yet the collective factors that influence AKL both within and across sex are not well understood. PURPOSE: To determine if postural factors may in part explain the magnitude of AKL. METHODS: The left lower extremities of 152 participants (87F, 65M; 22.7±3.1yrs, 71.6±15.2kg, 169.9±10.1cm) were clinically measured for pelvic angle (PA), hip anteversion (HA), tibiofemoral angle (TFA), genu recurvatuim (GR), tibial torsion (TT), femoral/tibial length ratio (FibTib) and navicular drop (ND). AKL was measured at 133N with a knee arthrometer. A single investigator with excellent measurement reliability (ICC2,3 > .87) collected all data. Three measurements for each variable were averaged for analysis. A stepwise linear regression was first performed on the entire sample, followed by separate analyses by sex. RESULTS: In the total sample GR, PA, ND and HA were significant predictors of AKL, explaining 27.3% of the variance. GR entered first, explaining 8.9% of the variance, with PA, ND, and HA explaining an additional 7.9%, 7.1% and 3.4% respectively (Sig. F change P<.02 each step). The prediction equation for this model was AKL = 6.273 + .103GR - .156PA -.168ND + .060HA. When analyzed by sex, GR, PA, ND and HA were again predictors in males (all P<.01), explaining 39.6% of the variance (AKL = 5.138 - .187PA + .252ND + .157HA + .180GR). However, only GR, ND and PA were predictors in females (all P<.03), and explained less variance (22.8%) (AKL = 6.440 + .127GR + .126ND - .095PA). Although HA was the next variable to enter the model for females, the R2 change (2.5%) was not significant (P = .105). CONCLUSION: Lower extremity posture may contribute to the magnitude of AKL. Specifically, greater HA, GR and ND, and decreased PA (all thought to influence rotational stress at the knee) were related to greater AKL. Of interest, HA, GR and PA tend to be higher on average in females, yet were stronger predictors of AKL in males. Other factors (e.g. changing hormone levels) may have a larger influence on AKL in females. Research is ongoing to understand the collective factors that contribute to greater AKL, and their effect on the weight bearing knee. Supported in part by NIH-NIAMS Grant R01- AR53172
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