The Combined Effect of Body Mass Index and Tibial Slope Angles on Anterior Cruciate Ligament Injury Risk in Male Knees: A Case-Control Study

Kızılgöz, Volkan; Sivrioğlu, Ali Kemal; Aydın, Hasan; Ulusoy, Gökhan Ragıp; Çetin, Türkhun; Tuncer, Kutsi

doi:10.1177/1179544119867922

Cited by 8 publications

(6 citation statements)

References 51 publications

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“…At present, many studies have assessed the morphological risk factors for anterior cruciate ligament (ACL) rupture. Risk factors for ACL rupture include a narrow intercondylar notch, lower notch width index (NWI), a smaller tibial eminence, a stenotic intercondylar notch shape, and increased tibial slope [2, 3, 5, 7, 12, 14]. The results of these studies can help individuals with these risk factors prevent ACL injuries during exercise [5].…”

Section: Introductionmentioning

confidence: 99%

“…The results of these studies can help individuals with these risk factors prevent ACL injuries during exercise [5]. The increased tibial slope is related to ACL injuries as the increased tibial slope can cause a greater anterior displacement of the tibia in sports [10, 12, 13]. In contrast, a decreased tibial slope is a risk factor for PCL rupture because an increased tibial slope can better prevent the tibia from moving backward excessively and avoid PCL injury [4, 9].…”

Section: Introductionmentioning

confidence: 99%

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Stenotic intercondylar notch is not a risk factor for posterior cruciate ligament rupture: a morphological analyses using magnetic resonance imaging

Liu

Zhang

Xiao

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The present study aimed to examine the factors related to the morphological characteristics of the femoral condyle in posterior cruciate ligament rupture in female and male populations. Methods One hundred and three patients (41 females, 62 males) with posterior cruciate ligament rupture from 2010 to 2020 were included in this retrospective case–control study. The sex and age of the posterior cruciate ligament rupture group were matched to those of the control group (41 females, 62 males; age range 16–69 years). Magnetic resonance imaging was used to measure the intercondylar notch width, femoral condylar width, and intercondylar notch angle in both the axial and coronal images. The ‘α’ angle was also measured using magnetic resonance imaging. The notch width index is the ratio of the intercondylar notch width to the femoral condylar width. Three types of intercondylar notch shapes (types A, U, and W) were evaluated in the axial magnetic resonance imaging images. Results The difference in the mean coronal notch width index between the study groups was statistically significant in the female population. The difference in the mean coronal femoral condylar width between the study groups was statistically significant in the male population. Conclusions A larger coronal notch width index was the greatest risk factor for posterior cruciate ligament rupture in the female population. In the male population, decreased coronal condylar width was the greatest risk factor for posterior cruciate ligament rupture. The results did not indicate that patients with a PCL rupture have a stenotic intercondylar notch. Posterior cruciate ligament injury prevention strategies could be applied to females with a larger coronal notch width index and males with a decreased condylar width. Levels of evidence Level III.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stenotic intercondylar notch is not a risk factor for posterior cruciate ligament rupture: a morphological analyses using magnetic resonance imaging

Liu

Zhang

Xiao

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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“…Another anthropometric risk factor for ACL injury in humans is increased body mass index (BMI), 6,36,37 and this appears to be a stronger risk factor in females than in males. 6 How elevated BMI increases the risk of ACL injury is unclear.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of sex differences in rodent anterior cruciate ligament injury

Liu

Rodeo

Deng

et al. 2022

Journal Orthopaedic Research

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The relative contributions of sex differences in anatomy, biomechanics, and hormones to the increased risk of anterior cruciate ligament (ACL) injury in female athletes remains unknown. The purpose of this study is to investigate sex differences in anatomy and biomechanics of the native and reconstructed ACL using our established murine model. A total of 140 12-week-old wild-type C57Bl/6 (70 male vs. 70 female) mice were used for this study. ACL reconstruction was performed on 120 mice who were split into four groups: Group 1 (30 males sacrificed at 14 days), Group 2 (30 females sacrificed at 14 days), Group 3 (30 males sacrificed at 28 days), and Group 4 (30 females sacrificed at 28 days). Tendon graftto-bone healing was assessed by biomechanical, histological, and micro-CT analysis.Twenty mice were used for baseline testing. Females showed significantly higher anterior (p < 0.05) and total displacement (p < 0.05). Males demonstrated a significantly higher load-to-failure force of native ACLs compared to females (p < 0.05). There was no significant difference in load-to-failure force in the ACL autograft. There were no significant sex differences in histological analysis of graft integration or tibial slope. The increased knee laxity and reduced load-to-failure of the native ACL observed in the female mice are consistent with some of the proposed risk factors driving the increased risk of ACL injury in females.Understanding the relative contributions of factors driving sex differences in material properties of the ACL will provide insight into the sex differences in ACL injury and future prevention strategies.

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“…The association between ACL injury and higher BMI was significant compared to athletes who did not have an ACL injury in this group. Elevated weight and BMI values have been found to be significantly associated with ACL injuries, especially in male individuals and associated with other intra-articular injuries observed during ACL reconstructions [13,27]. Further observational studies have shown that taller or heavier subjects are at a greater risk for injury because of the greater forces acting on the muscles, bones, and the connective tissues [28].…”

Section: Discussionmentioning

confidence: 99%

“…Further observational studies have shown that taller or heavier subjects are at a greater risk for injury because of the greater forces acting on the muscles, bones, and the connective tissues [28]. Other associated anatomical factors which were studied with BMI like the lateral tibial slope (LTS), medial tibial slope (MTS) and posterior tibial slope (PTS) were also predictive of ACL injury risk [27,28]. Our data confirms that BMI as a modifiable risk factor that should be improved and included in non-contact ACL injury prevention strategies.…”

Section: Discussionmentioning

confidence: 99%

The relationship of quadriceps (Q) angle and body mass index with non-contact anterior cruciate ligament injury among male athletes

Erandika¹,

Jayawardena

2020

SL Jnl. Sports & Exercise Med.

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The risk factors for non-contact ACL injuries are environmental, anatomical, hormonal biomechanical and neuromuscular [2,4]. Anatomical differences are increased tibial plateau slope, shallow medial tibial plateau depth [5], decreased intercondylar notch width, lower extremity malalignment including increased navicular drop, anterior pelvic tilt and Quadriceps (Q) angle [4,6].Quadriceps angle or Q angle is an anatomical feature defined as "the angle formed by a line from the anterior superior iliac spine (ASIS) to the patella center and a line from the patella

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The Combined Effect of Body Mass Index and Tibial Slope Angles on Anterior Cruciate Ligament Injury Risk in Male Knees: A Case-Control Study

Cited by 8 publications

References 51 publications

Stenotic intercondylar notch is not a risk factor for posterior cruciate ligament rupture: a morphological analyses using magnetic resonance imaging

Stenotic intercondylar notch is not a risk factor for posterior cruciate ligament rupture: a morphological analyses using magnetic resonance imaging

Evaluation of sex differences in rodent anterior cruciate ligament injury

The relationship of quadriceps (Q) angle and body mass index with non-contact anterior cruciate ligament injury among male athletes

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