Knee alignment in professional tennis players

This study determined lower-limb alignment and knee geometry in professional tennis players and compared the data with those from nonathletic individuals. Twenty-four radiographs from 12 asymptomatic players (mean age: 23.4+/-3.8 years) were prospectively studied. The three angles most useful for describing limb alignment and knee geometry in the coronal plane were measured: hip-knee-ankle, condylar-hip, and plateau-ankle. The condylar-plateau angle, frontal foot rotation angle, and the relationship between the mechanical axis and tibial plateau also were calculated. Varus limb alignment was predominant and the mechanical axis passed medially through the knee center; there was increased valgus inclination of the distal femur, varus angulation of the tibial plateau, near parallel alignment of the joint, and exaggerated external foot rotation. Hip-knee-ankle, condylar-hip, plateau-ankle, and frontal foot rotation angles were significantly different (P<.05, two-tailed t test) from previously reported angles of nonathletic individuals. Variations, probably due to repetitive dynamic demands imposed on lower limbs from an early age, seem to involve both femoral condyles and proximal tibial metaphyses, maintaining normal parallel joint alignment.