The Relationship Between Proximal Tibia Parameters And The Injury Of The Anterior Cruciate Ligament

Purpose:The purpose of this study was to:1) investigate the relationship between proximal tibia parameters and the injury of the anterior cruciate ligament (ACL), and to determine the influence of gender on these parameters;2) compare the reliability and consistency of the three methods (longitudinal axis, posterior and anterior tibial cortex axis) in measuring medial tibial plateau slope (PTS).Methods:Case-control study contained fifty two men and twenty women with non-contact ACL injuries were compared with the same number of men and women with meniscal injuries. Patients were matched for age and gender. All the patients were verified by arthroscopy, MRI and physical examination. There was no significant difference between ACL-injured subjects and control group in age, gender, height, weight, BMI and injury side.Results:The ACL injury group had no significant difference with the control group in tibia width. This result was still the same in the gender subgroup. The mean value of eminence width (EW) and eminence width index (EWI) in the ACL-injured patients compared with the control group, signifying a smaller eminence width and eminence width index among the ACL-injured patients. This difference was also statistically significant in male subgroup, but not female. For the total population and the male subgroup, the mean PTS of the ACL-injured group was significantly higher than that of the control group. Using a logistic regression model, the increased PTS and the decreased EWI remain significant risk factors. In addition, the longitudinal axis method exhibited the lowest interobserver and intraobserver variability and was not affected by age, sex, height, weight and BMI.Conclusions:The results of this study suggest that:1) increased PTS and decreased EWI were found to be associated with the risk of non-contact ACL injury in Chinese population. Despite the findings, this association only exists in male group or not remains unanswered because of the relatively smaller sample size in female group;2) the longitudinal axis method is recommended for measuring PTS in lateral radiograph in future studies.