Impact of sports participation on genu varum among youth: a systematic review

INTRODUCTION: Genu varum occurs more frequently among young male athletes involved in high levels of physical activity, particularly adolescent male soccer players when compared to the general population. This study provides a contemporary examination of the relationship between genu varum and participation in youth sport. SOURCES OF DATA: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The literature search was conducted in Web of Science, Scopus, PubMed, Embase, and CINAHL databases. AREAS OF AGREEMENT: Genu varum is more prevalent among athletes than among age-matched non-athlete controls and has been reported more often in male soccer players, with overloading of the proximal medial tibial growth plate proposed as a possible contributing mechanism. AREAS OF CONTROVERSY: Intercondylar-intermalleolar distance differed in younger age groups with some reporting negative values and some reporting positive values. GROWING POINTS: In recent years, there has been a marked improvement in the methods used to assess lower limb malalignment in young athletes. Clinical measures are simple but lack detail; whole-leg radiographs are increasingly used to capture these details. AREAS TIMELY FOR DEVELOPING RESEARCH: The lack of longitudinal data examining changes in lower extremity alignment with sports loading during the growth period is an important deficiency of the current research. Long-term follow-up studies are needed to clarify the nature and incidence of genu varum in young athletes, including females. Furthermore, the relationship between genu varum and non-soccer sports should be investigated so the movement and loading characteristics specific to different sports need to be evaluated.