Non-Contact ACL Injury: Can Anatomic Factors Be Used in Screening At-Risk Athletes?

Abstract

The authors are to be congratulated on their extensive case-control study of the sagittal geometry of the lateral knee compartment and its association with non-contact anterior cruciate ligament (ACL) injury. The underlying motivation for identifying risk factors is to recognize individuals at high risk for ACL injury and to intervene (when possible) to reduce the risk in those individuals. Unfortunately, if the results and conclusions of the study are reviewed from the perspective of a clinician hoping to identify individuals at high risk for non-contact ACL injury, there is no “tool” or guideline for how the risk factors can be used to assist the clinician. Female athletes have a risk of non-contact ACL injury that is two to five times that of male athletes. One might therefore expect female athletes to demonstrate the greatest effect size in the risk factors associated with non-contact ACL injury. However, the results of this study show no difference between injured and uninjured female subjects with respect to any of the six geometric parameters pertaining to the lateral knee compartment—the maximal anteroposterior femoral articular …