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- Title
Decreased femoral head-neck offset: a possible risk factor for ACL injury.
- Authors
Philippon, Marc; Dewing, Christopher; Briggs, Karen; Steadman, J.
- Abstract
Purpose: Reduction in anterior cruciate ligament (ACL) injuries in young, active individuals continues to be a major goal in sports medicine. The purpose of this study was to determine the head-neck offset, as measured by AP pelvis alpha angles, in patients presenting to a single surgeon with isolated ACL and non-ACL knee injuries. Methods: In a group of 48 patients with complete, primary ACL rupture and 42 controls with non-ACL injury (i.e., meniscus tear, cartilage defect), a single surgeon, blinded to the diagnosis, took radiographic measures of the AP alpha angle of both hips and the weight-bearing line at both knees. All knee pathology was confirmed with knee arthroscopy. Inclusion criteria included no previous hip or knee surgery, and long-leg standing alignment radiographic series completed at index visit. Results: There was no difference in gender distribution, height, BMI or age between groups. ACL-injured patients had a significantly higher alpha angle (mean = 84, SD = 14) on the injured side than the controls (mean = 59, SD = 7, p < 0.0001). Ninety-four percent of the ACL-injured group had alpha angles over 60°, while only 35% of the non-ACL-injured group had alpha angles over 60° ( p = 0.001). Those patients with alpha angle over 60° were 27 times more likely (95% CI 6.4-131) to be in the ACL injury group than those patients with alpha angle 60° or less ( p = 0.001). Conclusion: Our findings establish an important preliminary correlation between ACL injury and diminished femoral head-neck offset, as characterized by abnormal, elevated alpha angles. Level of evidence: Prognostic study, Level III.
- Subjects
CRUCIATE ligament injuries; ANTERIOR cruciate ligament injuries; ORTHOPEDICS; RADIOGRAPHY; ARTHROSCOPY; ANGLES; INJURY risk factors
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2012, Vol 20, Issue 12, p2585
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1007/s00167-012-1881-1