William Colyn1, Rintje Agricola2, Nele Arnout3, Jan A N Verhaar2, Johan Bellemans4. 1. Department of Orthopaedics, University Hospitals Leuven, Weligerveld 1, 3212, Pellenberg, Belgium. william_colyn@hotmail.com. 2. Department of Orthopaedics, Erasmus MC University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. 3. Department of Orthopaedics, University Hospital Ghent, De Pintelaan 185, 9000, Ghent, Belgium. 4. Department of Orthopaedics, Zol Genk, Schiepse Bos 6, 3600, Genk, Belgium.
Abstract
PURPOSE: The influence of type and intensity of sports during growth on knee alignment was investigated. The second aim was to ascertain whether the distal femur or proximal tibia contribute most to knee alignment. Also, the influence of field position and leg dominancy on knee alignment in soccer players was audited. METHODS: Standardized full-leg standing digital radiographs were obtained from 100 males and 100 females on which 8 different alignment parameters were measured. Participants were questioned on their sports activities during different stages of growth. Sports activities were graded according to the Tegner score. RESULTS: The mean (±SD) hip-knee-ankle angle (HKA) was significantly lower (p < 0.001) in high-activity male athletes (-2.8° ± 2.4°) than in low-activity male athletes (-0.9° ± 1.9°). No differences in HKA were observed between different activity levels in females. Males who practiced soccer between 10-12 years and 15-17 years had, in turn, a lower HKA than athletes practicing other high-activity sports in these age categories (mean difference ≥1.2°, p ≤ 0.046). The most contributing factor for the varus alignment in male soccer players was a lower medial proximal tibial angle (MPTA). CONCLUSION: High-activity sports participation during youth is associated with varus alignment at the end of growth in males. The most pronounced bowlegs were observed in male soccer players, and this was primarily determined by the proximal tibia. Adjustments in loads applied to the knees during skeletal growth in males might prevent the development of varus alignment and associated pathology, but further studies are required. LEVEL OF EVIDENCE: Diagnostic study, Level III.
PURPOSE: The influence of type and intensity of sports during growth on knee alignment was investigated. The second aim was to ascertain whether the distal femur or proximal tibia contribute most to knee alignment. Also, the influence of field position and leg dominancy on knee alignment in soccer players was audited. METHODS: Standardized full-leg standing digital radiographs were obtained from 100 males and 100 females on which 8 different alignment parameters were measured. Participants were questioned on their sports activities during different stages of growth. Sports activities were graded according to the Tegner score. RESULTS: The mean (±SD) hip-knee-ankle angle (HKA) was significantly lower (p < 0.001) in high-activity male athletes (-2.8° ± 2.4°) than in low-activity male athletes (-0.9° ± 1.9°). No differences in HKA were observed between different activity levels in females. Males who practiced soccer between 10-12 years and 15-17 years had, in turn, a lower HKA than athletes practicing other high-activity sports in these age categories (mean difference ≥1.2°, p ≤ 0.046). The most contributing factor for the varus alignment in male soccer players was a lower medial proximal tibial angle (MPTA). CONCLUSION: High-activity sports participation during youth is associated with varus alignment at the end of growth in males. The most pronounced bowlegs were observed in male soccer players, and this was primarily determined by the proximal tibia. Adjustments in loads applied to the knees during skeletal growth in males might prevent the development of varus alignment and associated pathology, but further studies are required. LEVEL OF EVIDENCE: Diagnostic study, Level III.
Entities:
Keywords:
Adaptation; Bowlegs; High-activity sports; Lower leg alignment; Soccer; Varus
Authors: Sharon Bout-Tabaku; Justine Shults; Babette S Zemel; Mary B Leonard; Robert I Berkowitz; Nicolas Stettler; Jon M Burnham Journal: J Rheumatol Date: 2014-11-01 Impact factor: 4.666
Authors: Adrian V Specogna; Trevor B Birmingham; Michael A Hunt; Ian C Jones; Thomas R Jenkyn; Peter J Fowler; J Robert Giffin Journal: Am J Sports Med Date: 2006-09-22 Impact factor: 6.202
Authors: Cesar de Cesar Netto; Alessio Bernasconi; Lauren Roberts; Pedro Augusto Pontin; Francois Lintz; Guilherme Honda Saito; Andrew Roney; Andrew Elliott; Martin O'Malley Journal: Orthop J Sports Med Date: 2019-02-21
Authors: Alessio Bernasconi; Cesar DE Cesar; Lauren Roberts; François Lintz; Alexandre Leme Godoy-Santos; Martin Joseph O'Malley Journal: Acta Ortop Bras Date: 2021 May-Jun Impact factor: 0.513
Authors: María Orosia Lucha-López; José Miguel Tricás-Moreno; Elena Gaspar-Calvo; Ana Carmen Lucha-López; Concepción Vidal-Peracho; César Hidalgo-García; Santos Caudevilla-Polo; Pablo Fanlo-Mazas Journal: J Int Med Res Date: 2018-06-25 Impact factor: 1.671