The aim of this study was to explore the association between developing coronal-plane leg alignment and activity levels during adolescence. We performed a cross-sectional cohort study with individuals from soccer club academies and an age-matched control population. Outcome measures were the hip knee angle (HKA), medial proximal tibial physeal angle (MPTPhyA), lateral distal femoral physeal angle (LDFPhyA) on full leg length magnetic reasonance imagine scans, and the physical activity questionnaire (PAQ) score. The cohort comprised 57 elite male soccer players, 34 male and 34 female controls aged 11−21 years. Mean HKA became more varus with age, with little change after 16 years or skeletal maturity. Skeletally mature elite male soccer players were significantly more varus than male controls with a HKA 2.28° less than male controls (p < 0.001). Skeletally mature male controls had a HKA 1.34° less than female controls (p < 0.001). A negative correlation existed between HKA and PAQ score (coefficient −0.24, p = 0.029). A positive correlation existed between HKA and MPTPhyA (coefficient 0.32, p = 0.008). In conclusion, high activity levels during adolescence are associated with the development of varus leg alignment. Mean HKA becomes more varus with age until skeletal maturity. The development of varus alignment may represent a physiological adaptation to load at the proximal tibial physis. Clinical Significance: A time period may exist for intervention before the development of varus leg alignment in young athletes, such as training load modification or proximal tibial morphology monitoring.

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青春期冠状面腿部排列和活动的影响：全腿长 MRI 研究

本研究的目的是探讨青春期冠状面腿部排列发育与活动水平之间的关联。我们对来自足球俱乐部学院的个人和年龄匹配的对照人群进行了横断面队列研究。结果指标是全腿长磁推理想象扫描的髋膝角 (HKA)、内侧近端胫骨骨骺角 (MPTPhyA)、外侧远端股骨骨骺角 (LDFPhyA) 和身体活动问卷 (PAQ) 评分。该队列包括 57 名精英男性足球运动员，34 名男性和 34 名女性对照，年龄在 11-21 岁之间。平均 HKA 随着年龄的增长变得更加内翻，在 16 岁或骨骼成熟后几乎没有变化。骨骼成熟的精英男性足球运动员内翻明显多于男性对照，HKA 比男性对照小 2.28°（p  < 0.001）。骨骼成熟的男性对照的 HKA 比女性对照低 1.34° ( p  < 0.001)。HKA 和 PAQ 评分之间存在负相关（系数 -0.24，p  = 0.029）。HKA 和 MPTPhyA 之间存在正相关（系数 0.32，p = 0.008）。总之，青春期的高活动水平与内翻腿排列的发展有关。平均 HKA 随着年龄的增长变得更加内翻，直到骨骼成熟。内翻对齐的发展可能代表了对胫骨近端处负荷的生理适应。临床意义：在年轻运动员发生内翻腿排列之前，可能存在一段干预时间，例如训练负荷调整或胫骨近端形态监测。