Study: Knee shape may affect ACL reconstruction need

July 5, 2013

Topic: injury prevention

Presenters at the American Orthopaedic Society for Sports Medicine Annual Meeting reported on the positive outcomes that followed meniscal repair.

ACL injuries are most common among athletes, and they can put players out of commission for entire seasons. Researchers recently released the results of a study that examined how the shape of the knee impacts a patient's need for ACL reconstruction. 

"This is the first study to show that after your ACL is ruptured, the changes in the mechanics of the knee can really be affected by the shape of the knee," said Suzanne Maher, Ph.D., coauthor of the study. "Previously, researchers had only conducted studies looking at whether a particular knee shape makes a person more likely to have an ACL injury, specifically in the athletic population."

The report noted that those who have experienced an ACL tear are at a high risk for osteoarthritis, joint degeneration and the depletion of vital knee cartilage, all of which can be circumvented with reconstructive surgery. However, nonoperative treatment is an option for individuals with more stable knees, as was made evident by a detailed cadaver study. Knees that experienced further damages to the front of the joint with the application of stress had a less concave tibial plateau than the other specimens. Maher noted that since a particularly deep valley in the tibial plateau gives the femur a solid place to sit, patients would not necessarily require the reconstructive surgery. 

The study may provide doctors with a way of determining who doesn't require ACL reconstructive surgery, but it is also fairly new and untested orthopaedic research. The sample size was only nine, the study was not conducted with active athletes, and it was focused on walking - not running or other high-impact exercises. However, the researchers still hope that it will help to shed some light on the effect the shape of the knee has on post-ACL tear patients. 

ACL injury prevention
The National Institutes of Health reported that an ACL injury frequently occurs after the patient engages the knee in a sudden twisting motion while landing on the same leg and holding the foot in a differing position. The tear is indicated by a loud popping sound. Young women are significantly more likely than their male counterparts to damage the ligament, but the injury can be avoided by making the effort to land on the ball of the feet instead of on a flat foot. 

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