ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
Persistent isokinetic knee flexion strength deficits at the time of return to sport are not associated with a second ACL injury.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. 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.
- Sex Differences in Knee Flexor Strength and Limb Symmetry Across Different Strength Testing Conditions in Healthy Recreational Athletes.Journal of clinical medicine · 2026Article
- Peroneus Longus Versus Hamstring Tendon Graft for Anterior Cruciate Ligament Reconstruction: A Retrospective Matched Comparison.Journal of clinical medicine · 2025Article
- Early Open Kinetic Chain Hamstring Exercise After ACL Reconstruction: A Retrospective Safety and Efficacy Study.Journal of clinical medicine · 2025Article
- Persistent isokinetic knee flexion strength deficits at the time of return to sport are not associated with a second ACL injury.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeTo investigate the rate of a second anterior cruciate ligament (ACL) injury based on different levels of knee flexion strength limb symmetry index (LSI) at the time of return to sport (RTS) after ACL reconstruction with hamstring tendon autograft.
methodsData was extracted from a rehabilitation registry for patients aged 15-40 years, who participated in knee-strenuous sports pre-injury (Tegner ≥ 6) and underwent ACL reconstruction with hamstring tendon autograft. Isokinetic knee flexion strength was analysed and reported as LSI. Patients were categorised into three groups (≥90%, 80%-89.9% and <80%) based on their LSI at reported time of RTS. Patients were followed for 2 years after ACL reconstruction to record a second ACL injury, and hazard ratios (HR) were calculated using a Cox proportional hazards model.
resultsA total of 526 patients (48% female, mean age 22 ± 6) were included, with 51 (9.7%) second ACL injuries recorded within 2 years after ACL reconstruction. Among patients with LSI ≥ 90% (71%), 43 second ACL injuries (11.0%) occurred. The LSI 80%-89.9% group had 4 second ACL injuries (4.0%), and the LSI < 80% group had four injuries (8.2%). Persistent knee flexion strength asymmetry did not significantly influence the hazard of a second ACL injury. The LSI 80%-89.9% group had a lower hazard (HR 0.34, confidence interval [CI]: 0.12-0.94), while the LSI < 80% group showed no significant difference (HR 0.70, CI: 0.25-1.97) compared with the LSI ≥ 90% group.
conclusionPersistent isokinetic concentric knee flexion strength asymmetry at RTS were not associated with a second ACL injury. LEVEL OF EVIDENCE: Level III.
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