Increased Lateral Tibial Plateau Slope Predisposes Male College Football Players to Anterior Cruciate Ligament Injury.
BACKGROUND
There are conflicting reports regarding the role of osseous morphologic characteristics such as an increased tibial slope as associated with an anterior cruciate ligament (ACL) injury. Few studies have analyzed the role of a combination of osseous morphologic characteristics in matched case control studies. The aim of this study was to determine if there is an association between osseous morphologic characteristics and ACL injury in male college American-football players.


METHODS
Ninety male U.S. National Collegiate Athletic Association (NCAA) Division-I 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-injured group) were matched for age, height, weight, and body mass index to subjects without an ACL injury (control group). Several osseous morphologic characteristics including medial and lateral condylar width, medial and lateral plateau width, notch width, bicondylar width, notch width index, and medial and lateral tibial slopes were measured and were compared between groups. Conditional logistic regression was used to analyze the data. Significance was set at p < 0.05.


RESULTS
According to univariable analysis, a narrower lateral femoral condyle (odds ratio, 0.82 [95% confidence interval (95% CI), 0.68 to 0.97]), increased medial tibial plateau slope (odds ratio, 1.42 [95% CI, 1.09 to 1.85]), and increased lateral tibial plateau slope (odds ratio, 1.43 [95% CI, 1.15 to 1.78]) were significantly associated with ACL injury. Multivariable analysis revealed that increased lateral tibial slope (odds ratio, 1.32 [95% CI, 1.03 to 1.70]) was the sole independent predictor of ACL injury.


CONCLUSIONS
Based on this study, osseous morphology, specifically increased lateral tibial slope, is associated with ACL injury in male college football players. These data might help to improve prevention strategies to lower ACL injury.


METHODS
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Ata A
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Rahnemai-Azar
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Zaneb
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Yaseen
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Carola F
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van Eck
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
James J
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Irrgang
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Freddie H
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Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania musahlv@upmc.edu.
Volker
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Musahl
D000293:Adolescent; D000070598:Anterior Cruciate Ligament Injuries / Q000000981:diagnostic imaging / Q000209:etiology*; D004198:Disease Susceptibility; D005538:Football; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D012307:Risk Factors; D013334:Students; D013977:Tibia / Q000000981:diagnostic imaging*; D014495:Universities; D055815:Young Adult