Anatomical Risk Factors for Lower Extremity Musculoskeletal Disorders and Proposed Prevention Strategies.

Area of Science:

• Orthopedics and Sports Medicine
• Biomechanical Engineering
• Developmental Biology

Background:

• Knee osteoarthritis (OA), patellofemoral pain, and anterior cruciate ligament (ACL) injuries are prevalent musculoskeletal disorders.
• These conditions are often managed with physical therapy, but underlying bone morphology and joint alignment play a significant role.
• Femoral anteversion, trochlear groove morphology, tibial alignment, and specific angles like the alpha angle are implicated in these disorders.

Purpose of the Study:

• To review bone morphological abnormalities and joint malalignments associated with major lower limb musculoskeletal disorders.
• To highlight these abnormalities as potential therapeutic targets, often overlooked in traditional approaches.
• To synthesize current understanding linking altered bone geometry during growth to increased disease risk.

Main Methods:

• Literature review summarizing studies on bone morphology and joint alignment in knee OA, patellofemoral pain, and ACL injuries.
• Analysis of findings from animal studies demonstrating the impact of mechanical loading on bone geometry during development.
• Synthesis of evidence connecting specific morphological parameters to disease risk.

Main Results:

• Abnormal femoral anteversion, trochlear groove shape, and patellofemoral alignment are linked to patellofemoral pain and instability.
• Tibial varus alignment (increased medial proximal tibial angle) is associated with knee OA.
• Abnormalities in femoral intercondylar width, alpha angle, and posterior tibial slope are risk factors for ACL injuries.
• Insufficient mechanical loading during growth can alter bone geometry and joint alignment, predisposing individuals to these disorders.

Conclusions:

• Bone morphological abnormalities and joint malalignments are significant risk factors for common lower limb musculoskeletal disorders.
• These factors, influenced by mechanical loading during growth, represent potential targets for preventative strategies.
• Integrating the assessment and potential correction of bone morphology could offer novel therapeutic avenues for musculoskeletal health.