The Influence of the Lower Limb Components on Genu Varum in Football Players

NCT06606964 | Completed

• 1 other identifier: KAEK-917
• Study Type: observational
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Objectives: To evaluate lower extremity alignments in football players with and without genu varum using magnetic resonance imaging (MRI), to determine the mechanisms underlying malalignment and the factors contributing to it. Methods: This is a prospective case-control study with football players with/without lower extremity malalignment. Full-length lower extremity MRI was used to evaluate the lower extremity alignment parameters. In addition, the isokinetic strength of the concentric knee extensor-flexor and concentric hip abductor-adductor muscles was measured using an isokinetic dynamometer at two different angular velocities: 60˚/sec and 180˚/sec. The investigators created a logistic regression model to investigate whether the alignment parameters used to evaluate lower extremity alignment in football players are risk factors for the development of genu varum.

Conditions

Genu Varum; Football Players

Keywords

Genu varum; Knee joint; Mechanical axis deviation; Isokinetic strength; Football players

Outcome Measures

Primary Outcomes (10)

• Mechanical axis deviation (MAD)

  The mechanical axis is a line connecting the center of the femoral head to the center of the ankle (center of the dome of the talus). A line was drawn from the center of the femoral head to the center of the ankle and the intersection of this line with the knee joint line was marked. The perpendicular distance from this intersection point to the center of the patella was measured as MAD.

  From enrollment to the end of measurements at 3 weeks

• Femoral anteversion (FA)

  On the axial images of the hip/pelvis covering the femoral head and neck, a line is drawn between the center of the femoral head and center of the femoral neck to calculate the uncorrected femoral anteversion angle. To correct for distal femoral rotation, another line is drawn along the posterior border of the femoral condyles to calculate the angle. Positive degrees between the femoral neck and the distal femoral axis are called femoral antetorsion; negative values were considered as femoral retrotorsion.

  From enrollment to the end of measurements at 3 weeks

• Medial proximal tibial angle (MPTA)

  The MPTA was defined as the medial angle between the proxsimal tibial joint line and the mechanical axis of the tibia. The proximal joint orientation line of tibia was drawn. A line was also drawn from the midpoint of the ankle to the midpoint of the knee on the tibial joint line. The angle between these two lines was measured.

  From enrollment to the end of measurements at 3 weeks

• Tibial torsion (TT)

  Proximal tibial axis (PTA) was placed along the posterior cortex of the tibial head at the level of condyls proximal to the fibular head. Distal tibial axis (DTA) was placed to the articular aspects of the medial and the lateral malleolus below the talar surface. The tibial torsion was calculated as the angle between the PTA and the DTA.

  From enrollment to the end of measurements at 3 weeks

• Tibial tubercle-trochlear groove (TT-TG) distance

  Firstly, transverse image that depicted a complete cartilaginous trochlea was used to determine the deepest point within the trochlear groove. A line was drawn through the deepest point of the trochlear groove, perpendicular to the posterior condylar tangent. Another line was drawn in parallel to the trochlear line through the most anterior portion of the tibial tubercle. Tibial tuberosity-trochlear groove distance was measured as the distance between these 2 lines.

  From enrollment to the end of measurements at 3 weeks

• Tibial tubercle-posterior cruciate ligament (TT-PCL)

  The TT-PCL distance was measured on axial images between the patellar tendon insertion midpoint and the medial border of the posterior cruciate ligament at its tibial insertion, parallel to the dorsal tibia condylar line.

  From enrollment to the end of measurements at 3 weeks

• Joint line convergence angle (JLCA)

  The mechanical axis line of femur was drawn, and then the knee joint line in the frontal plane was determined. The angle between these two lines was measured.

  From enrollment to the end of measurements at 3 weeks

• Hip-knee-ankle angle (HKA)

  The measurement was taken of the angle formed between the mechanical axis of the femur and tibia.

  From enrollment to the end of measurements at 3 weeks

• Mechanical lateral distal femoral angle (mLDFA)

  The distal joint orientation line of femur was drawn. A second line was drawn from the center of hip to the knee\'s midpoint at the femoral knee joint line (femoral mechanical axis). The angle between these two lines was measured.

  From enrollment to the end of measurements at 3 weeks

• Quadriceps femoris angle (Q angle)

  The angle between the lines connecting the anterior superior iliac spine (ASIS) to the midpoint of the patella, and from there to the tibial tubercle was measured.

  From enrollment to the end of measurements at 3 weeks

Secondary Outcomes (1)

• Isokinetic strength

  From enrollment to the end of measurements at 3 weeks

Study Arms (2)

Football players with genu varum

Football players with genu varum leg alignment

Diagnostic Test: Magnetic Resonance Imaging; Other: Isokinetic Strength

Football players without genu varum

Football players with normal lower extremity alignment

Diagnostic Test: Magnetic Resonance Imaging; Other: Isokinetic Strength

Interventions

Magnetic Resonance Imaging DIAGNOSTIC_TEST

The MRI examinations were conducted using a 1.5 Tesla closed MRI system with a body coil and spine coil. The participants\' knees were positioned in full extension and their feet were in a neutral position during imaging. The scan was performed from the anterior superior iliac spine to the tip of the toes, and both legs were included in the field of view

Football players with genu varum; Football players without genu varum

Isokinetic Strength OTHER

The strength of the concentric knee extensor-flexor and concentric hip abductor-adductor muscles was measured using an isokinetic dynamometer at two different angular velocities: 60˚/sec and 180˚/sec. Three repetitions were performed at 60˚/sec, and five repetitions were performed at 180˚/sec. To calculate the H/Q ratio, we divided the peak concentric torque of the hamstrings by that of the quadriceps during the same contraction velocity. Similarly, to determine the Add/Abd ratio, we divided the peak concentric torque of the adductors by that of the abductors during the same contraction velocity

Football players with genu varum; Football players without genu varum

Eligibility Criteria

• Age: 16 Years - 19 Years
• Sex: male
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

The study participants were selected from otherwise healthy football players aged 16-19 who currently play for a professional football club, have at least five years of football experience, train five days a week, and participate in official matches.

You may qualify if:

• Healthy football players who currently play for a professional football club
• Aged 16-19
• Have at least five years of football experience
• Train five days a week
• Participating in official matches.

You may not qualify if:

• History of musculoskeletal disease
• History of postural disorders
• History of previous surgery for lower extremity sports injuries
• History of fractures of the long bones of the lower extremity

Sponsors & Collaborators

• Tuba Melekoğlu: lead

Study Sites (1)

Akdeniz University Faculty of Sport Sciences

Antalya, Antalya, 07070, Turkey (Türkiye)

Location

Related Publications (2)

• Asadi K, Mirbolook A, Heidarzadeh A, Mardani Kivi M, Emami Meybodi MK, Rouhi Rad M. Association of Soccer and Genu Varum in Adolescents. Trauma Mon. 2015 May;20(2):e17184. doi: 10.5812/traumamon.17184. Epub 2015 May 25.

  PMID: 26290852 BACKGROUND

• Isin A, Kose O, Ak E, Emir Yetim E, Cevikol C, Melekoglu T. The influence of the lower limb components on genu varum in football players: a full leg length magnetic resonance imaging study. BMC Sports Sci Med Rehabil. 2025 Feb 25;17(1):25. doi: 10.1186/s13102-025-01075-9.

  PMID: 40001230 DERIVED

MeSH Terms

Conditions

Genu Varum

Interventions

Magnetic Resonance Imaging

Condition Hierarchy (Ancestors)

Bone Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Tomography; Diagnostic Imaging; Diagnostic Techniques and Procedures; Diagnosis

Study Officials

• Tuba Melekoglu, Phd

  Akdeniz University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assoc. Prof.

Study Record Dates

• First Submitted: September 16, 2024
• First Posted: September 23, 2024
• Study Start: December 1, 2021
• Primary Completion: December 30, 2022
• Study Completion: December 30, 2022
• Last Updated: September 23, 2024

Record last verified: 2024-09

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR
• Time Frame: The datasets generated during the current study will be available upon request from publishing date
• Access Criteria: The datasets generated during the current study will be available for researchers

Locations

TU (1)