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Genu VarumNCT06606964

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

An observational study of Genu Varum and Football Players, run by Tuba Melekoğlu at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial 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. Read more about this study

Who is it for?
Ages 16 to 19 years, men onlyHealthy volunteers can take part
Conditions the study is for
Genu Varum, Football Players
What is being tested?
Magnetic Resonance Imaging and Isokinetic Strength
How many people
36 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 Dec 2021to 30 Dec 2022
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 16 to 19 years
  • Men only
  • Healthy volunteers accepted
  • Child, Adult

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.

Who may be able to join

  • 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.

Who cannot join

  • 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

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Akdeniz University Faculty of Sport Sciences

    Antalya, Antalya, 07070

Other trials in Turkey (Türkiye)

About this study

Official title: The Influence of the Lower Limb Components on Genu Varum in Football Players: a Full Leg Length Magnetic Resonance Imaging Study

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.

Read the detailed description

Genu varum deformity is a common condition among football players, occurring in 73% of cases . Previous studies have shown that football players are at a higher risk of developing genu varum than athletes in other sports . Genu varum can have a negative impact on an athlete\'s physical abilities by disrupting static and dynamic balance through alterations in the gravitational axis of the lower extremities. In addition, genu varum can damage the tibiofemoral articular cartilage, increasing the risk of knee osteoarthritis later in life . It is also associated with several intra-articular pathologies, including meniscal lesions, anterior knee pain, and anterior cruciate ligament injuries . Therefore, it is important to understand the cause of this deformity and take protective-corrective measures for football players.

In recent years, researchers have studied the relationship between genu varum and football participation. Researchers have used various methods, including the caliper, goniometer, and photographic technique, to analyze deformities. However, these methods have limitations, making it difficult to examine etiological factors and differences in anthropometric components . In a study conducted by Colyn, Arnout, Verhaar and Bellemans 6, a comparison was made between football players and other athletes and non-athletes using digital radiology measurements. The findings indicated that male football players exhibited genu varum, with the proximal tibia identified as the primary factor determining this. Similarly, Krajnc and Drobnič studied lower limb alignment in asymptomatic adult professional football players and found that the proximal tibia was the source of varus deformity. However, it has been suggested that additional research is required to fully comprehend the involved mechanisms. Furthermore, Witvrouw, Danneels, Thijs, Cambier and Bellemans 9proposed that an imbalanced strength distribution between the adductor and abductor muscles may result in genu varum in football players. This is because kicking, a frequent activity in football, often strengthens the adductor muscles, which can alter the average adductor/abductor strength ratio. However, the authors note that no data on the adductor/abductor strength of football players is available in the literature. They suggest further research to address this knowledge gap.

Asymmetrical movements in football, resulting from the difference between the kicking and supporting legs, may lead to different mechanisms causing genu varum formation in the dominant and non-dominant legs. It is crucial to acknowledge that not all football players exhibit varus knee alignment. Consequently, in order to ascertain the mechanisms that contribute to the formation of genu varum, it is essential to conduct a comparative analysis between football players exhibiting and those lacking a varus deformity. This comparison can assist in identifying the mechanisms that cause genu varum in football players and the factors likely to contribute to these mechanisms. The study had three objectives: (i) to evaluate lower extremity alignments in football players with and without genu varum using magnetic resonance imaging (MRI), (ii) to determine the mechanisms underlying malalignment and the factors contributing to it; and (iii) to investigate the relationship between lower extremity alignment and isokinetic strength.

Being tested
Magnetic Resonance Imaging, Isokinetic Strength
Keywords
Genu varum, Knee joint, Mechanical axis deviation, Isokinetic strength, Football players
Medical subject headings
Genu Varum

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Magnetic Resonance ImagingDiagnostic 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

  • Isokinetic StrengthOther

    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

Study groups in NCT06606964
Study groupRoleWhat they receive
Football players with genu varumFootball players with genu varum leg alignment
Receives: Diagnostic Test: Magnetic Resonance Imaging; Other: Isokinetic Strength
Football players without genu varumFootball players with normal lower extremity alignment
Receives: Diagnostic Test: Magnetic Resonance Imaging; Other: Isokinetic Strength

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 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.

    Measured: From enrollment to the end of measurements at 3 weeks

  2. 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.

    Measured: From enrollment to the end of measurements at 3 weeks

  3. 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.

    Measured: From enrollment to the end of measurements at 3 weeks

  4. 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.

    Measured: From enrollment to the end of measurements at 3 weeks

  5. 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.

    Measured: From enrollment to the end of measurements at 3 weeks

  6. 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.

    Measured: From enrollment to the end of measurements at 3 weeks

  7. 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.

    Measured: From enrollment to the end of measurements at 3 weeks

  8. Hip-knee-ankle angle (HKA)

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

    Measured: From enrollment to the end of measurements at 3 weeks

  9. 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.

    Measured: From enrollment to the end of measurements at 3 weeks

  10. 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.

    Measured: From enrollment to the end of measurements at 3 weeks

Secondary outcomes (1)
  1. Isokinetic strength

    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.

    Measured: From enrollment to the end of measurements at 3 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Sep 2024
  2. Study start1 Dec 2021
  3. Primary completion30 Dec 2022
  4. Study completion30 Dec 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
36 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06606964
Sponsor's protocol ID
KAEK-917
Status last verified
Sep 2024
First submitted
16 Sep 2024
Last updated
23 Sep 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The datasets generated during the current study will be available upon request from corresponder author Tuba Melekoğlu

Publications

  • 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.

    PubMed 26290852
  • 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.

    PubMed 40001230

Questions about this trial

What is this clinical trial studying?

An observational study of Genu Varum and Football Players, run by Tuba Melekoğlu at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 23 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mechanical axis deviation (MAD) (time frame: From enrollment to the end of measurements at 3 weeks). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06606964, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Sep 2024.

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