Sundberg Axel, Senorski Rebecca Hamrin, Högberg Johan, Piussi Ramana, Samuelsson Kristian, Thomeé Roland, Senorski Eric Hamrin
Capio Ortho Center, Gothenburg, Sweden.
Sahlgrenska Sports Medicine Center (SSMC), Gothenburg, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2025 Aug;33(8):2971-2983. doi: 10.1002/ksa.12718. Epub 2025 Jun 8.
To 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.
Data 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.
A 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.
Persistent isokinetic concentric knee flexion strength asymmetry at RTS were not associated with a second ACL injury.
Level III.
研究自体腘绳肌腱重建前交叉韧带（ACL）后，在恢复运动（RTS）时基于不同水平的膝关节屈曲力量肢体对称指数（LSI）的二次ACL损伤发生率。
从康复登记处提取数据，纳入年龄在15 - 40岁、伤前参加剧烈膝关节运动（Tegner≥6）且接受自体腘绳肌腱ACL重建的患者。分析等速膝关节屈曲力量并以LSI报告。根据RTS报告时间的LSI将患者分为三组（≥90%、80% - 89.9%和<80%）。ACL重建后对患者随访2年以记录二次ACL损伤，并使用Cox比例风险模型计算风险比（HR）。
共纳入526例患者（48%为女性，平均年龄22±6岁），ACL重建后2年内记录到51例（9.7%）二次ACL损伤。在LSI≥90%的患者中（71%），发生了43例二次ACL损伤（11.0%）。LSI为80% - 89.9%组有4例二次ACL损伤（4.0%），LSI<80%组有4例损伤（8.2%）。持续的膝关节屈曲力量不对称并未显著影响二次ACL损伤的风险。与LSI≥90%组相比，LSI为80% - 89.9%组风险较低（HR 0.34，置信区间[CI]：0.12 - 0.94），而LSI<80%组无显著差异（HR 0.70，CI：0.25 - 1.97）。
RTS时持续的等速向心膝关节屈曲力量不对称与二次ACL损伤无关。
III级。
