Tibial Spine Height Measured by Radiograph Is a Risk Factor for Non-Contact Anterior Cruciate Ligament Injury in Males: A Retrospective Case-Control Study

Various anatomic abnormalities are implicated in non-contact anterior cruciate ligament (ACL) injury, but researchers rarely deal with the relation between tibial spine height and ACL injury. We conducted a retrospective case-control study to include 96 patients with and without non-contact ACL injuries. Tibial plateau width (TPW), medial and lateral tibial spine height (MTSH and LTSH), and tibial spine width (TSW) were measured by radiographs. The parameters were compared among subgroups. Binary regression mode, receiver operating characteristic curves, and the area under the curve (AUC) were used to evaluate the specific correlation of the parameters with ACL injury. As a result, we found that the ratio of LTSH/TPW was larger in ACL-injured patients than in ACL-intact controls ( p = 0.015). In the study group, LTSH/TPW ( p = 0.007) and MTSH/TPW ( p = 0.002) were larger in males than in females. The ratio of LTSH/TPW had an AUC of 0.60 and a significant OR of 1.3 for ACL injury in males, but not in females. In conclusion, LTSH was larger in patients with ACL injury and is a risk factor for ACL injury in males. The impact of increased LTSH on the impingement between the grafts and lateral tibial spine during ACL reconstruction warrants further investigation.