Sun Jingyi, Zhao Yingqi, Gao Feng, Qian Yi, Zhou Jingbin
Sports Medicine and Rehabilitation Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China.
Key Laboratory of Sports Trauma and Rehabilitation of the General Administration of Sport of China, Beijing, China.
Orthop J Sports Med. 2025 Jul 16;13(7):23259671251352205. doi: 10.1177/23259671251352205. eCollection 2025 Jul.
Some patients still experience mild residual rotational laxity of the knee after anterior cruciate ligament reconstruction (ACLR). The clinical symptoms of this residual rotational laxity are controversial, and methods for evaluating the symptoms have become a focus of academic interest in recent years. It is unclear whether there is a correlation between mild residual rotational laxity after ACLR and performance.
To investigate the influence of residual mild rotational laxity after ACLR on subjective outcomes, performance, psychological readiness, and return to sports (RTS).
Cross-sectional study; Level of evidence, 3.
A total of 81 patients who underwent ACLR at our sports medicine center were observed for >2 years. The follow-up included KT-2000 measurements, the pivot shift test (PST), subjective outcome scores (Lysholm, International Knee Documentation Committee Subjective Knee [IKDC], Knee injury and Osteoarthritis Outcome Score [KOOS], ACL-Return to Sport after Injury Score [ACL-RSI], Tegner score, and Marx score), and performance evaluations, such as isokinetic testing at 60 deg/sec, hop tests, and Y-balance tests (YBT). Patients were grouped based on the results of the last PST follow-up on the operated knee. The stable group (SG) consisted of 42 patients with negative PST results, while the mild rotational laxity group (MIG) comprised 39 patients with PST grade 1. Statistical analysis was conducted to compare patient characteristics, subjective outcome scores, and performance between the 2 groups.
Significant differences were observed between the 2 groups in the single-leg hop test, the triple hop test, and the cross-over hop limb symmetry index, respectively ( = .013; = .017; = .046). In addition, the SG had significantly higher ACL-RSI scores than the MIG (69.54 ± 21.34 vs 53.60 ± 21.66; = .006); and postoperative Tegner scores were significantly higher in the SG compared with the MIG (5.81±1.70 vs 4.95 ± 1.93; = .036). No significant differences were observed in Lysholm, IKDC, KOOS score, postoperative Marx, or KT-2000 side-to-side difference scores, and no significant differences were found in isokinetic testing at 60 deg/sec, hamstring-to-quadriceps ratio, or YBT results between the 2 groups.
Residual mild rotational laxity in the knee after ACLR leads to poorer performance in hop tests and a lower level of activity, and poor psychological readiness. Furthermore, in short- to medium-term follow-up after ACLR, regardless of knee rotational laxity, the return to preinjury activity rate remains low, with the majority not meeting the safe RTS criteria.
部分患者在前交叉韧带重建术（ACLR）后仍存在膝关节轻度残余旋转松弛。这种残余旋转松弛的临床症状存在争议，近年来评估这些症状的方法已成为学术关注的焦点。目前尚不清楚ACLR术后轻度残余旋转松弛与运动表现之间是否存在关联。
探讨ACLR术后残余轻度旋转松弛对主观结果、运动表现、心理准备情况及恢复运动（RTS）的影响。
横断面研究；证据等级为3级。
对我院运动医学中心81例行ACLR手术的患者进行了超过2年的观察。随访内容包括KT-2000测量、轴移试验（PST）、主观结果评分（Lysholm评分、国际膝关节文献委员会主观膝关节[IKDC]评分、膝关节损伤和骨关节炎结果评分[KOOS]、ACL损伤后恢复运动评分[ACL-RSI]、Tegner评分和Marx评分）以及运动表现评估，如60°/秒等速测试、单腿跳测试和Y平衡测试（YBT）。根据患侧膝关节最后一次PST随访结果对患者进行分组。稳定组（SG）由42例PST结果为阴性的患者组成，而轻度旋转松弛组（MIG）包括39例PST为1级的患者。进行统计分析以比较两组患者的特征、主观结果评分和运动表现。
两组在单腿跳测试、三级跳测试和交叉跳肢体对称指数方面分别存在显著差异（P = 0.013；P = 0.017；P = 0.046）。此外，SG组的ACL-RSI评分显著高于MIG组（69.54±21.34对53.60±21.66；P = 0.006）；SG组术后Tegner评分显著高于MIG组（5.81±1.70对4.95±1.93；P = 0.036）。两组在Lysholm评分、IKDC评分、KOOS评分、术后Marx评分或KT-2000双侧差值评分方面未观察到显著差异，在60°/秒等速测试、腘绳肌与股四头肌比值或YBT结果方面也未发现显著差异。
ACLR术后膝关节残余轻度旋转松弛导致单腿跳测试中的运动表现较差、活动水平较低以及心理准备不足。此外，在ACLR术后的短期至中期随访中，无论膝关节旋转松弛情况如何，恢复到伤前活动水平的比例仍然较低，大多数患者未达到安全的RTS标准。
