Increased Slope of the Lateral Tibial Plateau Subchondral Bone Is Associated With Greater Risk of Noncontact ACL Injury in Females but Not in Males

Abstract

There is a 21.7% increased risk of noncontact ACL injury with each degree increase of the lateral tibial plateau slope among females but not among males. The medial tibial plateau slope, coronal tibial slope, and depth of the medial tibial plateau were not associated with risk of injury for females or males.

ACL Research Retreat VII: An Update on Anterior Cruciate Ligament Injury Risk Factor Identification, Screening, and Prevention

“…[95][96][97][98] In addition, reduced condylar depth of the medial tibial plateau may be characteristic of ACL injury. 96,97,100 Coronal slope has not been associated with ACL injury risk. 97,100 Multivariate analyses suggest that smaller ACL volume and femoral notch width at the inlet and outlet and greater anteromedial bony ridge thickness and posterior-inferior directed slope of the lateral tibial compartment may independently contribute to injury risk and together provide more information on injury risk potential.…”

“…Knee-Joint Geometry. The majority of prospective and retrospective case-control studies comparing ACL-injured patients with uninjured controls indicate that ACL-injured patients have smaller ACLs (in area and volume), 94,95 greater lateral posterior-inferior tibial plateau slopes (but not necessarily medial tibial slopes), [96][97][98][99][100] and smaller femoral notch widths and notch width indexes. 95,98,[101][102][103][104][105][106][107][108] The presence of a more prominent or thicker bony ridge on the anteromedial outlet of the femoral intercondylar notch has also been reported in ACL-injured patients versus controls.…”

A Sex-Stratified Multivariate Risk Factor Model for Anterior Cruciate Ligament Injury

“…The second phase focused on a multivariate evaluation of knee-joint geometry and its effect on the risk of ACL injury. [16][17][18][19][20][21] Detailed results from the first phase are currently under review for publication and, consequently, we can provide only an overview of the study design, but we encourage the reader to consider the detailed findings once they have been published. The findings from the multivariate work in the second phase have been published.…”

“…The findings from the multivariate work in the second phase have been published. [16][17][18][19][20][21] Athletes from 36 institutions (8 colleges, 28 high schools) were monitored prospectively over 4 years for the occurrence of ACL injuries. A total of 109 case participants (70 females, 39 males) who sustained a first-time grade III noncontact ACL injury during involvement in a schoolorganized sport were enrolled in the study.…”

“…Bilateral 3-T images were obtained on all case and control participants and used to measure 32 aspects of knee anatomy. 11,16,19,21 Multivariate analysis revealed differences between females and males for the specific aspects of knee-joint geometry that had the greatest association with ACL injury risk. When male athletes were considered as a group, decreases in the wedge angle of the posterior lateral meniscal horn and ACL volume had the highest associations with the risk of sustaining a noncontact ACL injury (odds ratio [OR] ¼ 1.23 per 18 decrease in wedge angle and OR ¼ 1.43 per 0.1-cm 3 decrease in ACL volume).…”