Abstract: BACKGROUND: Studies have shown that posterior cruciate ligament injuries are associated with the anatomical morphology of the knee joint.
OBJECTIVE: To explore anatomical morphological risk factors for posterior cruciate ligament injury.
METHODS: The imaging data of 142 patients who visited Affiliated Hospital of Binzhou Medical University for knee joint problems from January 2015 to August 2022 were retrospectively analyzed. They were divided into posterior cruciate ligament injury group (n=71, including 49 males and 22 females) and posterior cruciate ligament intact group (n=71, including 49 males and 22 females). Intercondylar notch width, intercondylar notch height, bicondyle width, notch width index, angle of intercondylar notch, Blumensaat’s line inlication angle, medial tibial spine height, lateral tibial spine height, tibial spine width, tibiofemoral consistency index, tibial plateau anterior-posterior diameter, medial tibial depth and patellar tendon-tibial shaft angle were measured on MRI images. Posterior tibial slope was measured on X-ray images. The above indicators were included in the logistic regression analysis for investigation. 
RESULTS AND CONCLUSION:  (1) Univariate logistic regression analysis in men showed that tibial spine width, tibiofemoral consistency index, medial tibial depth, and posterior tibial slope were associated with posterior cruciate ligament injury (P < 0.05). Multivariate binary logistic regression analysis showed that tibiofemoral consistency index and medial tibial depth were associated with posterior cruciate ligament damage (P < 0.05). (2) Univariate logistic regression analysis in women showed that medial tibial spine height, lateral tibial spine height, tibial spine width, and posterior tibial slope were associated with posterior cruciate ligament injury (P < 0.05). Multivariate binary logistic regression analysis showed that posterior tibial slope was associated with posterior cruciate ligament damage (P < 0.05). (3) The receiver operating characteristic curve showed that tibiofemoral consistency index, medial tibial depth and posterior tibial slope had a certain predictive value on posterior cruciate ligament damage. (4) These findings suggest that anatomical morphological risk factors for posterior cruciate ligament injury differ between men and women, and tibial spine width and posterior tibial slope are common risk factors. In the male population, abnormal tibial spine width, tibiofemoral consistency index, medial tibial depth, and posterior tibial slope are easy to induce posterior cruciate ligament injury. In the female population, abnormal medial tibial spine height, lateral tibial spine height, tibial spine width, and posterior tibial slope are easy to induce posterior cruciate ligament injury. Clinicians can use the above risk factors to identify abnormal knee morphology, assess people at risk of posterior cruciate ligament injury, and provide preventive advice and guidance for treatment.

Key words: posterior cruciate ligament, anatomical morphological risk factor, femoral condyle, tibial plateau, anatomy, imaging