How does lower leg alignment differ between soccer players, other athletes, and non-athletic controls?

Area of Science:

• Orthopedics and Sports Medicine
• Pediatric Growth and Development
• Biomechanics

Background:

• Knee alignment is crucial for joint health and can be influenced by physical activity during developmental stages.
• Understanding the biomechanical factors contributing to knee alignment is essential for preventing long-term musculoskeletal issues.

Purpose of the Study:

• To investigate how sports type and intensity during growth affect knee alignment in young individuals.
• To determine whether the distal femur or proximal tibia is more influential in shaping knee alignment.
• To examine the impact of specific factors like field position and leg dominance in soccer players on knee alignment.

Main Methods:

• A diagnostic study (Level III) involving 200 participants (100 males, 100 females).
• Standardized full-leg standing digital radiographs were used to measure 8 alignment parameters.
• Participants provided detailed histories of sports participation during growth, with activities graded using the Tegner score.

Main Results:

• Male athletes with high activity levels exhibited significantly lower hip-knee-ankle angles (HKA) compared to low-activity males (p < 0.001).
• No significant differences in HKA were found between activity levels in females.
• Male soccer players showed lower HKA, with tibial morphology (medial proximal tibial angle) being the primary contributor to varus alignment.

Conclusions:

• Intense sports participation during male adolescence is associated with the development of varus knee alignment.
• Male soccer players demonstrated the most pronounced varus alignment, predominantly influenced by proximal tibial characteristics.
• Modulating knee loading during skeletal growth in males may offer a strategy to prevent varus alignment and related pathologies, warranting further research.