股骨髁间窝形态与ACL损伤风险的性别分层分析：系统综述与Meta分析
简介
该研究通过系统综述和荟萃分析，探讨股骨髁间窝形态与ACL损伤风险的性别差异。纳入24项研究，其中22项提供定量数据。关键发现：ACL损伤膝的髁间窝宽度在女性（平均差-1.74 mm，95% CI -2.54至-0.95）和男性（平均差-1.31 mm，95% CI -1.94至-0.68）中均显著窄于对照组，但异质性高（I² 81-95%）。髁间窝宽度指数（…
英文摘要
BACKGROUND: Anterior cruciate ligament (ACL) injury is more common in females. Although ACL injury risk is multifactorial, involving neuromuscular, hormonal, and biomechanical factors, femoral intercondylar notch morphology is a proposed non-modifiable anatomical contributor that may help explain this disparity. This review synthesizes evidence on its association with ACL injury risk, analyses stratified by male and female sex. METHODS: A literature search of PubMed, Web of Science, and Scopus was conducted through January 2026. After duplicate removal, 527 unique records were screened and 134 full texts assessed for eligibility. Twenty-four studies met inclusion criteria, with 22 providing quantitative data. Data were extracted on ACL-injured (ACLi) and control (ACLc) knees, stratified by sex. RESULTS: ACLi knees had narrower notch widths than ACLc knees in both females (MD -1.74 mm, 95% CI -2.54 to -0.95) and males (MD -1.31 mm, 95% CI -1.94 to -0.68), with substantial heterogeneity (I2 81-95%). NWI differences were significant in males (MD -0.01, 95% CI -0.02 to 0.00) but not females. Limited notch shape data suggested higher ACL injury odds with A-shaped notches in females (OR 2.85, 95% CI 0.07-110.66) and males (OR 1.67, 95% CI 0.00-3.98 × 105). CONCLUSION: Narrower femoral intercondylar notch width was consistently associated with ACL injury in both sexes, whereas findings for NWI and notch shape were limited by heterogeneity and sparse data. These results provide a structured synthesis of sex-specific anatomical risk factors and support femoral notch narrowing as a shared contributor, while highlighting the need for prospective, standardized studies in the future.