Background. Knee position provides useful information for the anatomical alignment of the lower extremity. Analyzing the geometric components of this alignment should yield useful information about how these factors affect the occurrence of an ankle sprain. The aim of this study is to investigate the correlation among these anthropometric characteristics and the possible future occurrence of ankle sprain injuries. Material and methods. A total of 60 elite athletes (25.2 ± 3.2 years) participated in the current study. The data used for measuring knee surface alignment were the following: anatomical alignment angle (AA), condylar hip angle (CH), tibial plateau angle (PA), and joint surface (condylar plateau) angle (CP). Standardized radiography was used in all measurements. All knee alignment measurements were made on digital radiographs. The study lasted for 18 months. A logistic regression (probit) was used for the statistical analysis of the outcomes. A significance level of P = .05 was considered. Results. The knee angle factors (AA, CH, PA, and CP) proved to be statistically nonsignificant (P > .05). Conclusions. The geometric knee surface alignment factors do not seem to be a decisive factor that would increase the probability of spraining an ankle.
Levels of Evidence: Prognostic Level IV: Case Series
CookeTDHarrisonLKhanBScudamore AChaudhary. Analysis of limb alignment in the pathogenesis of osteoarthritis: a comparison of Saudi Arabian and Canadian cases. Rheumatol Int. 2002;22:160-164.
2.
ChaoEYNeluheniEVHsuRWPaleyD. Biomechanics of malalignment. Orthop Clin North Am. 1994;25:379-386.
3.
HardingML. A fresh appraisal of tibial osteotomy for osteoarthritis of the knee. Clin Orthop Relat Res. 1976;114:223-234.
4.
CookeTDHarrisonLKhanBScudamoreAChaudharyMA. Analysis of limb alignment in the pathogenesis of osteoarthritis: a comparison of Saudi Arabian and Canadian cases. Rheumatol Int. 2002;22:160-164.
5.
CookeTD. Definition of axial alignment of the lower extremity. J Bone Joint Surg Am. 2002;84-A:146-147.
6.
CookeTDLiJScudamoreRA. Radiographic assessment of bony contributions to knee deformity. Orthop Clin North Am. 1994;25:387-393.
7.
CookeTDVScudamoreA. Healthy knee alignment and mechanics. In: CallaghanJJRosenbergAGRubashHE, eds. The Adult Knee. Philadelphia, PA: Lippincott Williams & Wilkins; 2003:175-186.
8.
GarrickJG. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med. 1977;5:241-242.
9.
FongDTHongYChanLKYungPSChanKM. A systematic review on ankle injury and ankle sprain in sports. Sports Med. 2007;37:73-94.
10.
ShambaughJPKleinAHerbertJH. Structural measures as predictors of injury basketball players. Med Sci Sports Exerc. 1991;23:522-527.
11.
BruceDBMurphyDFAlosaDM. Predictive factors for lateral ankle sprains: a literature review. J Athl Train. 2002;37:376-380.
12.
NaganoAIshigeYFukashiroS. Comparison of new approaches to estimate mechanical output of individual joints in vertical jumps. J Biomech. 1998;31:951-955.
13.
BahrRHolmeI. Risk factors for sports injuries: a methodological approach. Br J Sports Med. 2003;37:384-392.
SanfridssonJRydLSvahnGFridenTJonssonK. Radiographic measurement of femorotibial rotation in weight-bearing: the influence of flexion and extension in the knee on the extensor mechanism and angles of the lower extremity in a healthy population. Acta Radiol. 2001;42:207-217.
16.
HsuRWHimenoSCoventryMBChaoEY. Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res. 1990;255:215-227.
17.
IssaSNDunlopDChangA. Full-limb and knee radiography assessments of varus-valgus alignment and their relationship to osteoarthritis disease features by magnetic resonance imaging. Arthritis Rheum. 2007;57:398-406.
18.
KrausVBVailTPWorrellTMcDanielG. A comparative assessment of alignment angle of the knee by radiographic and physical examination methods. Arthritis Rheum. 2005;52:1730-1735.
19.
MorelandJRBassettLWHankerGJ. Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am. 1987;69:745-749.
20.
YoshiokaYSiuDCookeTD. The anatomy and functional axes of the femur. J Bone Joint Surg Am. 1987;69:873-880.
21.
HinmanRSMayRLCrossleyKM. Is there an alternative to the full-leg radiograph for determining knee joint alignment in osteoarthritis?Arthritis Rheum. 2006;55:306-313.
22.
CookeTDScudamoreRABryantJTSorbieCSiuDFisherB. A quantitative approach to radiography of the lower limb: principles and applications. J Bone Joint Surg Br. 1991;73:715-720.
23.
PrakashUWigderowitzCAMcGurtyDWRowleyDI. Computerized measurement of tibiofemoral alignment. J Bone Joint Surg Br. 2001;83:819-824.
24.
SledECostiganPCookeTDSheehyLHundtHQiuM. Measuring malalignment in knee OA [abstract]. Osteoarthritis Cartilage. 2005;13:S120.
25.
RozzanigoUPizzoliAMinariCCaudanaR. Alignment and articular orientation of lower limbs: manual vs computer aided measurements on digital radiograms. Radiol Med. 2005;109:234-238.
26.
HankemeierSGoslingTRichterMHufnerTHochhausenCKrettekC. Computer-assisted analysis of lower limb geometry: higher intraobserver reliability compared to conventional method. Comput Aided Surg. 2006;11:81-86.
27.
SitlerMRRyanJWheelerB. The efficacy of a semirigid ankle stabilizer to reduce acute ankle injuries in basketball: a randomized clinical study at West Point. Am J Sports Med. 1994;22:454-461.
28.
SpecognaAVBirminghamTBDaSilvaJJ. Reliability of lower limb frontal plane alignment measurements using plain radiographs and digitized images. J Knee Surg. 2004;17:203-210.
29.
TakahashiTYamanakaNKomatsuMOgawaYYoshidaSYamamotoH. A new computer-assisted method for measuring the tibio-femoral angle in patients with osteoarthritis of the knee. Osteoarthritis Cartilage. 2004;12:256-259.
30.
NelsonEABragaLBraga-BaiakA. Static knee alignment measurements among Caucasians and African-Americans: the Johnston County Osteoarthritis Project. J Rheumatol. 2009;36:1987-1990.
31.
McKayGDGoldiePAPayneWR. Ankle injuries in basketball: injury rate and risk factors. Br J Sports Med. 2001;35:103-108.
32.
GujaratiD. Basic Econometrics. 4th ed.New York, NY: McGraw-Hill; 2003.
33.
KennedyP. A Guide to Econometrics. 3rd ed.Cambridge, MA: MIT Press: 1992.
34.
CharretteM. Abnormal Q angle and orthotic support. Dynamic Chiropractic. 2003;21.
35.
GrossMT. Lower quarter screening for skeletal malalignment: suggestions for orthotics and shoe wear. J Orthop Sports Phys Ther. 1995;21:389-405.
36.
CowanDNJoneBFrykmanPN. Lower limb morphology and risk of overuse injury among male infantry trainees. Med Sci Sports Exerc. 1996;28:945-952.
37.
GizaEFullerCJungeA. Mechanisms of foot and ankle injuries in soccer. Am J Sports Med. 2003;31:550-554.
38.
StevensonMRHamerPFinchF. Sport, age, and sex specific incidence of sports injuries in Western Australia. Br J Sports Med. 2000;34:188-194.
39.
ZeliskoJANobleHBPorterM. A comparison of men’s and women’s professional basketball injuries. Am J Sports Med. 1982;10:297-299.
40.
BeynnonBDMurphyDFAlosaDM. Predictive factors for lateral ankle sprains: a literature review. J Athl Train. 2002;37:376-380.
41.
VerhagenEAVan der BeekBouterLM. A one season prospective cohort study of volleyball injuries. Br J Sports Med. 2004;38:477-481.
42.
BarrettJRTanjiJLDrakeC. High versus low-top shoes for the prevention of ankle sprains in basketball players: a prospective randomized study. Am J Sports Med. 1993;21:582-585.
43.
PefanisNPapaharalampousXTsiganosGPapadakouEBaltopoulosP. The effect of Q angle on ankle sprain occurrence. Foot Ankle Spec. 2009;2:22-26.
44.
PefanisNKaragounisPTsiganosGArmenisEBaltopoulosP. Tibiofemoral angle and its relation to ankle sprain occurrence. Foot Ankle Spec. 2009;2:271-276.
