ArticleThe American journal of sports medicine2024
Physiologic Preoperative Knee Hyperextension Is Not Associated With Postoperative Laxity, Subjective Knee Function, or Revision Surgery After ACL Reconstruction With Hamstring Tendon Autografts.
Article in The American journal of sports medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Generalised joint hypermobility and excess knee hyperextension are associated with an increased risk for second ACL injury, but not primary ACL injury, in female football players: A 5-year follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Advances in anterior cruciate ligament reconstruction: Risk stratification, graft choices, and functional recovery in 2026.Journal of experimental orthopaedics · 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
- Knee hyperextension is not associated with anterior knee laxity, subjective knee function or revision surgery after anterior cruciate ligament reconstruction in children and adolescents.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Comparable short-term anterior knee laxity and extension outcomes following anterior cruciate ligament reconstruction using TightRope II RT, TightRope RT and EndoButton CL: A retrospective matched cohort study.Journal of experimental orthopaedics · 2025Article
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5 authors.
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Abstract
backgroundThere is concern that physiologic knee hyperextension may be associated with inferior outcomes after anterior cruciate ligament reconstruction (ACLR) using hamstring tendon (HT) autografts. PURPOSE: To assess whether there is an association between contralateral passive preoperative knee hyperextension (≤-5°) and postoperative anterior knee laxity, subjective knee function, or revision surgery after ACLR using HT autografts. STUDY
designCohort study; Level of evidence, 3.
methodsPatients without concomitant ligament injuries who underwent primary ACLR using an HT autograft at Capio Artro Clinic, Stockholm, Sweden, between January 1, 2005, and December 31, 2018, were identified. The cohort was dichotomized into the hyperextension group (≤-5°) and the no hyperextension group (>-5°) depending on preoperative contralateral passive knee extension degree. Anterior knee laxity (KT-1000 arthrometer; 134 N) was assessed preoperatively and at 6 months postoperatively. The Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and at 1, 2, and 5 years postoperatively. Patients who underwent revision ACLR at any institution in Sweden within 5 years of the primary surgery were identified in the Swedish National Knee Ligament Registry.
resultsA total of 6104 patients (53.5% male) for whom knee range of motion measurements were available were identified (hyperextension group [≤-5°]: 2350 [38.5%]; mean extension, -6.1°± 2.3° [range, -20° to -5°]; no hyperextension group [>-5°]: 3754 [61.5%]; mean extension, 0°± 1.4° [range, -4° to 15°]). There were no intergroup differences in anterior knee laxity preoperatively (hyperextension group, 3.6 ± 2.8 mm; no hyperextension group, 3.7 ± 2.7 mm;
conclusionPreoperative passive contralateral knee hyperextension (≤-5°) was not associated with postoperative anterior knee laxity, subjective knee function, or revision surgery ≤5 years after ACLR using HT autografts. Therefore, the presence of knee hyperextension alone should not be considered a contraindication per se for the use of HT autografts in ACLR.
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