ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016
How does lower leg alignment differ between soccer players, other athletes, and non-athletic controls?
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Impact of sports participation on genu varum among youth: a systematic review.British medical bulletin · 2026Pooled it
- Bowlegs and Intensive Football Training in Children and Adolescents.Deutsches Arzteblatt international · 2018Pooled it
- Two-year follow-up of varus progression in young professional football players.BMC sports science, medicine & rehabilitation · 2026Article
- Coronal Plane Alignment of the Knee (CPAK) in children and adolescents : an analysis of 655 knees according to the CPAK classification.Bone & joint open · 2026Article
- Tibial genu varum and primary cam morphology in healthy young adults: A cross-sectional study uncovering the double threat to joint health.Osteoarthritis and cartilage open · 2026Article
- Effects of Thigh and Leg Rotation on Sagittal Knee Angle During Static Assessment.Journal of functional morphology and kinesiology · 2025Article
- Youth soccer players: patterns of injury involving the primary growth plates of epiphyses.Skeletal radiology · 2025Review
- Analysis of Genu Varum in Young Male Professional Soccer Players.Orthopaedic journal of sports medicine · 2025Article
- The influence of the lower limb components on genu varum in football players: a full leg length magnetic resonance imaging study.BMC sports science, medicine & rehabilitation · 2025Article
- High Prevalence of Varus Knee Malalignment in Adolescent Football Players-Clinical Lower Leg Axis Measurements of Male Junior Football Players Aged 7 to 18 Years.Children (Basel, Switzerland) · 2024Article
- Influence of leg axis alignment on MRI T2* mapping of the knee in young professional soccer players.BMC musculoskeletal disorders · 2024Article
- The Coronal Alignment of Lower Limbs in the Adolescent Football and Ice Hockey Players.Indian journal of orthopaedics · 2024Article
- Comparison of Early Complication Rates After High Tibial Osteotomy Versus Unicompartmental Knee Arthroplasty for Knee Osteoarthritis.Orthopaedic journal of sports medicine · 2024Article
- Radiographic Measures for the Assessment of Frontal and Sagittal Knee Alignments and the Associated Normality Values: A Meta-Analysis.Journal of chiropractic medicine · 2023Review
- Automated Artificial Intelligence-Based Assessment of Lower Limb Alignment Validated on Weight-Bearing Pre- and Postoperative Full-Leg Radiographs.Diagnostics (Basel, Switzerland) · 2022Article
- Evidence-based rationale for treatment of meniscal lesions in athletes.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Review
- The contralateral limb is no reliable reference to restore coronal alignment in TKA.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Specific case consideration for implanting TKA with the Kinematic Alignment technique.EFORT open reviews · 2021Review
- Foot Alignment in Symptomatic National Basketball Association Players Using Weightbearing Cone Beam Computed Tomography.Orthopaedic journal of sports medicine · 2019Article
- Relationship between knee alignment in asymptomatic subjects and flexibility of the main muscles that are functionally related to the knee.The Journal of international medical research · 2018Article
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe influence of type and intensity of sports during growth on knee alignment was investigated. The second aim was to ascertain whether the distal femur or proximal tibia contribute most to knee alignment. Also, the influence of field position and leg dominancy on knee alignment in soccer players was audited.
methodsStandardized full-leg standing digital radiographs were obtained from 100 males and 100 females on which 8 different alignment parameters were measured. Participants were questioned on their sports activities during different stages of growth. Sports activities were graded according to the Tegner score.
resultsThe mean (±SD) hip-knee-ankle angle (HKA) was significantly lower (p < 0.001) in high-activity male athletes (-2.8° ± 2.4°) than in low-activity male athletes (-0.9° ± 1.9°). No differences in HKA were observed between different activity levels in females. Males who practiced soccer between 10-12 years and 15-17 years had, in turn, a lower HKA than athletes practicing other high-activity sports in these age categories (mean difference ≥1.2°, p ≤ 0.046). The most contributing factor for the varus alignment in male soccer players was a lower medial proximal tibial angle (MPTA).
conclusionHigh-activity sports participation during youth is associated with varus alignment at the end of growth in males. The most pronounced bowlegs were observed in male soccer players, and this was primarily determined by the proximal tibia. Adjustments in loads applied to the knees during skeletal growth in males might prevent the development of varus alignment and associated pathology, but further studies are required. LEVEL OF EVIDENCE: Diagnostic study, Level III.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.