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Multivariable analysis of anatomic risk factors for anterior cruciate ligament injury in active individuals

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Objective

The aim of the present study was to compare the morphometric differences between patients with or without anterior cruciate ligament (ACL) injury, and identify the anatomic risk factors associated with ACL injury in active individuals.

Methods

The knee joint magnetic resonance images (MRI) of 100 subjects were included in this study. Data from the ACL-injured group (50 patients) and matched controls (50 subjects) were obtained from the same hospital. These data were analyzed by univariable analysis or multivariable conditional logistic regression analysis to examine the effects of the following variables on the risk of suffering ACL injury for the first time: TT-TG distance, medial and lateral tibial slope, intercondylar notch width and depth, femur condylar width, lateral femoral condylar depth, notch width index (NWI), notch shape index (NSI), notch depth index (NDI), and cross-sectional area (CSA).

Results

In the univariable analysis, the ACL-injured group had a larger TT-TG distance, increased medial and lateral tibial slope, narrower intercondylar notch width, deeper lateral femoral condylar depth, lesser NWI and NSI, and CSA when compared with the control group (P < 0.05). However, there were no significant between-group differences in intercondylar notch depth (P = 0.174), femur condylar width (P = 0.797), and NDI (P = 0.436). The multivariable analysis revealed that TT-TG distance [odds ratio (OR) = 1.37, 95% CI = 1.04–1.81, P = 0.028], medial tibial slope (OR = 1.30, 95% CI = 1.02–1.66, P = 0.036) and NWI (OR = 0.46, 95% CI = 0.24–0.91, P = 0.025) had significant multivariable associations with the sole independent risk of ACL injury.

Conclusion

Larger TT-TG distance, increased MTS, and lesser NWI are independent anatomic risk factors for active individuals with ACL injury.

Level of evidence

Case-control study; Level of Evidence, III.

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Author notes

  1. Xianyue Shen and Jianlin Xiao contributed equally to this study.

Authors and Affiliations

  1. Department of Orthopedics, China-Japan Union Hospital of Jilin University, Jilin province, Changchun, People’s Republic of China

    Xianyue Shen, Jianlin Xiao, Tong Liu, Zhongli Gao & Jianlin Zuo

  2. Department of Orthopedics, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Guangzhou, Guangdong Province, People’s Republic of China

    Yuhui Yang

  3. Norman Bethune Medical School, Jilin University, Jilin province, Changchun, People’s Republic of China

    Shangjun Chen

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  1. Xianyue Shen
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Shen, X., Xiao, J., Yang, Y. et al. Multivariable analysis of anatomic risk factors for anterior cruciate ligament injury in active individuals. Arch Orthop Trauma Surg 139, 1277–1285 (2019). https://doi.org/10.1007/s00402-019-03210-x

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