Predicting ACL rupture in the population actively engaged in sports activities based on anatomical risk factors

The purposes of this article were identification (ie, verification and gradation) of anatomical risk factors that lead to anterior cruciate ligament (ACL) injury and determination of the probability of ACL injury among the population actively engaged in sports activities. We evaluated 66 patients divided into 2 groups: 33 patients in the examined group diagnosed with ACL lesion, and 33 patients in the control group diagnosed with patellofemoral pain. Patients were matched by age, sex, type of lesion, and whether the lesion was left or right sided. Measurements were carried out by radiography and magnetic resonance imaging. The study examined 32 anatomical factors. After identifying factors that lead to ACL injury, the following were determined: the coefficient of significance for each individual factor via the discriminant analysis and the canonical discriminant (i.e., canonical correlation). Fifteen factors in men and 8 factors in women were differentiated as having influence on ACL injury. Based on these factors, it was determined whether the patients belonged to the examined or the control group with a success rate of 100% in men (100% sensitivity and specificity) and 91.7% in women (100% sensitivity and 83.3% specificity). The anatomy of the ACL prone to rupture and of the skeletal structures influencing it is significantly different from the anatomy of the ACL ligament resistant to injury. The probability of precise prognosis of ACL injury based on differentiated anatomical factors is 88.9% in men and 75.7% in women actively engaged in sports activities.