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INTRODUCTION
Anterior cruciate ligament (ACL) injury is one
of the most severe injuries in sport. Three quar
ters of anterior cruciate ligament injuries are
non contact injuries. Furthermore, Wright [1]
described a controlateral ACL tear rate of 12%.
Surgical techniques have evolved dramatically
in the past decade thanks to arthroscopic
techniques, graft choices and bony fixation
techniques.
Understanding the mechanism of failure is
critical to otpimize prevention strategies.
Prevention programmes work on the risk
factors of ACL injuries: They include intrinsic
factors and extrinsic factors.
Intrinsic risk factors try to explain the
mechanism of non contact ACL injury
including anatomical factors (tibial slope and
intercondylar notch stenosis), gender factors,
gene factors, biomechanical factors (knee
valgus, knee recurvatum, joint laxity)
neuromuscular deficit.
ANATOMICAL FACTORS
Tibial slope
Tibial plateau slope is one of the most often
stated anatomic structures that could cause
ACL injuries in the literature. Biomechanical
studies have demonstrated that translation of
the tibia resulted from the tibia plateau slope
and created an anteriorly directly applied force.
The tibial plateau must influence the
in situ
force of the ACL [2].
Tibial plateau slope is defined through several
medical examinations either X-ray or in an
MRI [3]. There is no significant difference
between the radiographic methods and the
MRI.
The most important findings of the meta-
analysis [2] is that medial tibial plateau slope
(MTPS) and lateral tibial plateau slope
(LTPS) are risk factors for ACL [4]. In an
X-ray, tibial slope is defined as the angle
between a line on the surface of the plateau
and a tibial anatomic reference. The angle is
within the range of 5-7°.
INTRINSIC RISK FACTORS
OF ANTERIOR CRUCIATE
LIGAMENT INJURY: REVIEW
G. ESTOUR, A. PINAROLI, L. BUISSON