Tibiofemoral joint congruence is lower in females with ACL injuries than males with ACL injuries

Previous research has demonstrated that women have a higher risk of anterior cruciate ligament (ACL) injury than men. Tibiofemoral articular geometry may play a role in the occurrence of ACL tears. The purpose of this study was to analyze the gender-specific geometric characteristics differences in tibiofemoral morphology in ACL-deficient patients. Medial tibial slope (MTS), lateral tibial slope (LTS), medial tibial plateau concavity, medial and lateral femoral condyle convexity, and lateral plateau convexity were analyzed in 276 patients with complete ACL injuries (138 females and 138 males). Two blinded observers measured the anatomical parameters of tibiofemoral geometry with use of multiplanar CT scans. Intra- and inter-rater reliabilities were assessed and comparisons between anatomic measures were made between male and female patients. The average ICC for all measurements was 0.90 (range 0.83–0.97) indicating good reliability. Male ACL injured patients demonstrated significantly greater LTS (10.5° ± 2.8) than female patients (9.6° ± 3.5°; p