INTRODUCTION: Anterior cruciate ligament (ACL) rupture is a severe knee injury, leading to functional instability and degenerative joint disease. Risk factors proximal to the knee joint have been highly emphasized in the last decade, but less attention has been focused on risk factors located distal to the knee. Subtalar hyperpronation (SH) has been suggested by some authors as a possible risk factor for ACL injuries, but the evidences regarding this matter are still scarce and inconclusive. OBJECTIVE: The purpose of this study was to carry out a review of literature studies that have performed assessments of the subtalar joint alignment associated to ACL injuries or associated to other known risk factors for this injury. MATERIALS AND METHODS: A search in electronic databases (PubMed, MEDLINE, COCHRANE, Web of Science, PEDro, SciELO, LILACS and EMBASE) was performed from 1966 to 2011. RESULTS AND DISCUSSION: Nine clinical studies were found to be pertinent to this matter. Among these, four studies have identified SH in subjects with ACL injury and one study has found a correlation between SH and other risk factors for ACL injury. The inexistence of correlation between these variables in the other studies is probably due to methodological differences in the assessments. It should be noted that the retrospective nature of the studies found does not allow the establishment of cause and consequence in this context. Prospective studies, with more methodological uniformity, are necessary for the definitive establishment of SH as an effective risk factor for ACL injuries.
Pronation; Talocalcaneal joint; Anterior cruciate ligament; Knee joint
