ArticleBMC sports science, medicine & rehabilitation2023
Lower rates of return to sport in patients with generalised joint hypermobility two years after ACL reconstruction: a prospective cohort study.
Article in BMC sports science, medicine & rehabilitation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Beighton Scoring System Use in Generalized Joint Hypermobility Studies Has Greater Scientific Rigor Than Joint-Specific or Arthroscopy Joint Hypermobility Studies.Arthroscopy, sports medicine, and rehabilitation · 2026Review
- Age is not a primary risk factor for anterior cruciate ligament injury-A comprehensive review of anterior cruciate ligament injury and reinjury risk factors confounded by young patient age.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Review
- Greater psychological response and participation in knee-strenuous activity 8 months after anterior cruciate ligament reconstruction in patients with generalised joint hypermobility who sustained a second anterior cruciate ligament injury: A cross-sectional registry study.Journal of experimental orthopaedics · 2025Article
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Authors and funding
8 authors.
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Abstract
backgroundGeneralised joint hypermobility (GJH) has been associated with an increased risk of suffering an anterior cruciate ligament (ACL) injury. Patients with GJH exhibit lower muscle strength and poorer scores for patient-reported outcomes after ACL reconstruction, compared with patients without GJH. The aim of this study was to examine differences in the percentages of patients who return to sport (RTS) or pre-injury level of activity (RTP), muscle function and patient-reported outcomes at the time of RTS or RTP, as well as the time of RTS or RTP in patients with GJH compared with patients without GJH in the first two years after ACL reconstruction.
methodsThis prospective study used data from an ACL- and rehabilitation-specific register located in Gothenburg, Sweden. Patients aged between 16 and 50, who had a primary ACL injury treated with reconstruction, were included. Data up to two years after ACL reconstruction were used and consisted of achieving RTS and RTP, results from isokinetic muscle function tests for knee extension and flexion and patient-reported outcomes (Knee Self-Efficacy Scale, Knee injury and Osteoarthritis Outcome Score and ACL-Return to Sport after Injury scale) at the time of RTS, as well as the time of RTP. A Beighton Score of ≥ 5/9 was used to define GJH. A Tegner Activity Scale of ≥ 6 was used to define RTS, while a Tegner equal to or above pre-injury level was used to define RTP.
resultsA total of 1,198 patients (54.7% women) with a mean age of 28.5 ± 8.6 years were included. A smaller proportion of patients with GJH achieved RTS compared with patients without GJH (49.2% vs. 57.3%, Odds ratio: 0.720, p = 0.041). Furthermore, patients with GJH were marginally less symmetrical on the knee extension strength test, expressed as a Limb Symmetry Index, at the time of RTP compared with patients without GJH (87.3 ± 13.5 vs. 91.7 ± 14.3, Cohen's d = 0.142, p = 0.022). No further differences were found between groups regarding any muscle function tests or patient-reported outcomes.
conclusionA smaller proportion of patients with GJH achieved RTS compared with patients without GJH. Patients with GJH displayed less symmetrical knee extension strength at the time of RTP compared with patients without GJH.
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