Latest research on ACL injury and reconstruction

97 papers, newest 30 shown · updated 2026-09-26 · Sports Medicine · All topics

The newest papers on ACL injury and reconstruction from the orthopaedic journals The Reduction reads, newest first, each with a one-line summary. The list is drawn from the digest’s archive and refreshed every week.

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Recent papers

  1. Association of Early Knee Extension Range of Motion Deficits With Cartilage T2 Relaxation Following Anterior Cruciate Ligament Reconstruction.

    American Journal of Sports Medicine · Sep 2026 · PubMed

    In 30 patients after ACL reconstruction, knee extension deficits at 2 months were linked to worsening medial femoral cartilage T2 relaxation at 6 months, suggesting early ROM loss may accelerate cartilage degeneration and OA risk.

  2. From Fear to Function: How Physiotherapists Navigate Psychological Challenges in Patients Undergoing Rehabilitation After ACL Reconstruction.

    Sports Health · Sep 24 2026 · PubMed

    Focus groups with experienced physiotherapists show they rely on communication, goal-setting, and graded exposure to address psychological readiness after ACL reconstruction, but lack formal training in this area.

  3. Anterior tibial translation in anterior cruciate ligament-deficient knees is increased regardless of tear location and independently associated with early-to-intermediate injury chronicity.

    Knee Surgery, Sports Traumatology, Arthroscopy · Sep 21 2026 · PubMed

    In 521 ACL surgery patients, only injury chronicity (not tear location) independently predicted anterior tibial translation, so tear type shouldn't be used to predict knee laxity.

  4. Beyond clinical grading: rethinking arthrogenic muscle inhibition after anterior cruciate ligament reconstruction.

    Knee Surgery, Sports Traumatology, Arthroscopy · Sep 19 2026 · PubMed

    This commentary argues the SANTI classification is useful for clinically screening arthrogenic muscle inhibition after ACL reconstruction but should not be equated with mechanistic measures like voluntary activation testing.

  5. Lack of Knee Confidence Is Associated With Lower Functional Scores After Anterior Cruciate Ligament Reconstruction at 2-Year Follow-Up.

    Arthroscopy · Sep 18 2026 · PubMed

    Among 165 ACLR patients, persistent lack of knee confidence at 2 years was linked to significantly lower activity and sports function scores, independent of age, sex, or graft type.

  6. Improved Activity, Return to Sport, and Graft Survivorship With Suture-Augmented Versus Isolated Revision Anterior Cruciate Ligament Reconstruction Using All-Soft-Tissue Grafts.

    Arthroscopy · Sep 17 2026 · PubMed

    In revision ACL reconstruction with soft-tissue grafts, adding suture augmentation improved activity scores, reduced graft failure, and increased return-to-sport rates compared to isolated reconstruction.

  7. Poor Synovial Sheath Integrity Is Associated With an Increased Failure Rate After Anterior Cruciate Ligament Primary Repair.

    Arthroscopy · Sep 16 2026 · PubMed

    In ACL primary repair, poor synovial sheath integrity (<50%) and younger age independently predicted repair failure, and worse sheath integrity correlated with more complex tear patterns and worse outcomes.

  8. Increased medial posterior tibial slope is associated with greater postoperative anterior tibial translation over time after anterior cruciate ligament reconstruction.

    Knee Surgery, Sports Traumatology, Arthroscopy · Sep 16 2026 · PubMed

    Steeper medial posterior tibial slope was linked to progressively greater postoperative anterior tibial translation after ACL reconstruction, an effect lessened by lateral extra-articular tenodesis but worsened by older age and medial cartilage damage.

  9. The mechanism of injury's role in jump landing mechanics after anterior cruciate ligament reconstruction.

    Knee Surgery, Sports Traumatology, Arthroscopy · Sep 16 2026 · PubMed

    Among 129 post-ACLR patients, landing mechanics (LESS scores), strength, and patient-reported outcomes did not differ between contact and noncontact injury mechanisms, supporting continued focus on landing mechanics in rehab regardless of injury type.

  10. ACL injury mechanism in elite and recreational handball players.

    Knee Surgery, Sports Traumatology, Arthroscopy · Sep 16 2026 · PubMed

    A large Danish registry study found most handball ACL injuries were non-contact, occurring during pivoting or landing while in ball possession, especially among back-line players on offense.

  11. Chondral Lesion Severity and Location Are Not Associated With Return-to-Play Outcomes After Anterior Cruciate Ligament Reconstruction.

    Arthroscopy · Sep 15 2026 · PubMed

    In 441 ACL reconstruction patients with concomitant chondral lesions, cartilage severity and location did not affect return-to-play rates, timing, or performance at 5 years, though high-grade medial lesions predicted worse PROs.

  12. More Horizontal ACL Posterolateral Bundle Position in Osteochondritis Dissecans of the Lateral Femoral Condyle.

    American Journal of Sports Medicine · Sep 15 2026 · PubMed

    MRI analysis found a more horizontal, distally attached ACL posterolateral bundle associated with lateral femoral condyle osteochondritis dissecans, suggesting a possible role in disease pathogenesis and healing prediction.

  13. Psychological readiness is associated with long-term joint awareness after isolated anterior cruciate ligament reconstruction: A within-patient comparison with the contralateral healthy knee.

    Knee Surgery, Sports Traumatology, Arthroscopy · Sep 14 2026 · PubMed

    Despite good objective stability after ACL reconstruction, reconstructed knees still feel less 'forgotten' than the healthy knee, and greater psychological readiness (ACL-RSI) is strongly linked to better long-term joint awareness.

  14. Outcomes after anterior cruciate ligament reconstruction with versus without lateral extra-articular tenodesis: A propensity-matched cohort study.

    Knee Surgery, Sports Traumatology, Arthroscopy · Sep 12 2026 · PubMed

    In a large propensity-matched database study, adding lateral extra-articular tenodesis to ACL reconstruction was associated with more early complications, arthrofibrosis, meniscal reoperation, and osteoarthritis without reducing revision ACL surgery, urging careful patient selection.

  15. Delphi Expert Consensus Identifies Revision Surgery, High-Grade Pivot Shift, and High-Risk Athletes in Pivoting Sports as Indications for Anterolateral Ligament Reconstruction or Lateral Extra-articular Procedures in Anterior Cruciate Ligament Reconstruction.

    Arthroscopy · Sep 12 2026 · PubMed

    A 40-expert Delphi consensus supports anterolateral ligament reconstruction or lateral extra-articular procedures for high-grade pivot shift, revision ACL surgery, and high-risk pivoting athletes, but not routine use in all ACL patients.

  16. Functional and Psychological Predictors of Return to Sport and Reinjury Risk in Professional Athletes After ACL Reconstruction.

    Sports Health · Sep 11 2026 · PubMed

    In professional athletes after ACLR, absolute hop performance combined with psychological readiness (ACL-RSI) predicted reinjury risk better than traditional limb symmetry index thresholds.

  17. The role of generalised joint Laxity in anterior cruciate ligament reconstruction: A systematic review and meta-analysis.

    Knee Surgery, Sports Traumatology, Arthroscopy · Sep 11 2026 · PubMed

    Meta-analysis of 13 studies shows generalized joint laxity is linked to greater residual knee laxity after ACL reconstruction, though graft failure rates and clinical outcomes remain inconsistently affected.

  18. Association of Slope-Reducing Osteotomy With Return to Preinjury Level of Sport After Failed Anterior Cruciate Ligament Reconstruction in Elite Athletes.

    American Journal of Sports Medicine · Sep 11 2026 · PubMed

    In elite athletes with high posterior tibial slope and failed ACLR, combining slope-reducing osteotomy with revision ACLR enabled all patients to return to preinjury sport level with excellent functional outcomes and no graft failures.

  19. Changes and Compensatory Gait Mechanisms in Lower Extremity Kinematics in Patients With ACL Rupture: A Cross-sectional Controlled Study.

    Sports Health · Sep 11 2026 · PubMed

    Patients with ACL rupture showed bilateral gait changes—reduced hip external rotation/adduction and ankle internal rotation plus lower affected-side knee flexion—supporting rehab that addresses both limbs.

  20. Effects of Quadriceps Strength Recovery in the First Year After Anterior Cruciate Ligament Reconstruction on Gait Biomechanics.

    Sports Health · Sep 11 2026 · PubMed

    In ACLR patients, those with weaker quadriceps recovery show more persistent abnormal knee gait mechanics than stronger-recovery patients, and neither group fully normalizes to controls—supporting adjunct gait-focused rehab beyond strength training alone.

  21. Bone Grafting Using Manually Contoured Femoral Head and Neck Allograft Successfully Fills Femoral and Tibial Tunnel Osteolytic Defects in 2-Stage Revision Anterior Cruciate Ligament Reconstruction: A Computed Tomography-Guided Analysis.

    Arthroscopy · Sep 10 2026 · PubMed

    CT analysis showed manually contoured femoral head/neck allograft achieved 68-92% filling of tibial and femoral tunnel osteolytic defects before 2-stage revision ACL reconstruction, with lower cost than prefabricated dowels.

  22. Timing of Noncontact Anterior Cruciate Ligament Injury According to Developmental Stage in Japanese Female Athletes.

    Clinical Journal of Sport Medicine · Sep 09 2026 · PubMed

    In 335 Japanese female athletes, noncontact ACL injuries peaked during late puberty (84%), identifying this developmental stage as a key risk period.

  23. Absolute Risk of Anterior Cruciate Ligament Graft Reruptures From the Posterior Tibial Slope Falls With Increasing Age: A Risk Stratification Analysis.

    American Journal of Sports Medicine · Sep 07 2026 · PubMed

    Increasing age markedly lowers the absolute (but not relative) ACL graft rerupture risk from elevated posterior tibial slope, supporting age-integrated slope-based risk stratification before ACL reconstruction.

  24. Combined Ramp Lesion and Lateral Meniscus Root Tear Increase Rotational and Translational Instability in an Anterior Cruciate Ligament-Deficient Knee: A Cadaveric Study.

    Arthroscopy · Sep 06 2026 · PubMed

    Cadaveric testing showed that combining a ramp lesion with a lateral meniscus root tear in an ACL-deficient knee significantly worsens rotational and anterior translational instability compared to either lesion alone.

  25. Graft type is not associated with revision ACL reconstruction in football players: a nationwide cohort analysis of subsequent ACL reconstructions.

    British Journal of Sports Medicine · Sep 03 2026 · PubMed

    In a large Swedish registry study of football players, ACL autograft type was not associated with revision ACL reconstruction, though quadriceps tendon grafts were linked to higher contralateral ACL injury risk in women.

  26. The Coronal Lateral Collateral Ligament Sign Occurs Independent of Generalized Joint Hyperlaxity in Children and Adolescents With ACL-Deficient Knees.

    Journal of Pediatric Orthopaedics · Sep 01 2026 · PubMed

    Lateral collateral ligament sign in ACL-deficient pediatric knees occurs independent of generalized joint hyperlaxity, suggesting ACL-specific instability indicator.

  27. Correlation Between Synovial Coverage of the Reconstructed Anterior Cruciate Ligament and Healing of Bucket-Handle Medial Meniscal Tears After Combined ACL Reconstruction and Meniscal Repair.

    Orthopaedic Journal of Sports Medicine · Aug 2026 · PubMed

    In 59 patients undergoing combined ACL reconstruction and bucket-handle medial meniscal repair, greater arthroscopic synovial coverage of the ACL graft strongly correlated with meniscal healing, suggesting synovialization as a biological marker of repair success.

  28. Biomechanical Effect of Medial Collateral Ligament Repair With and Without Suture Augmentation on Knee Laxity and Anterior Cruciate Ligament Force.

    American Journal of Sports Medicine · Aug 31 2026 · PubMed

    Cadaveric study shows MCL repair with or without suture augmentation reduces ACL force versus a cut MCL, but adding augmentation only modestly lowers residual valgus laxity at mid-flexion angles.

  29. Risk of Revision and Patient-Reported Outcomes After ACL Reconstruction: Influence of Concomitant MCL Injury and Graft Choice: Analysis of 35,139 Reconstructions From the Norwegian Knee Ligament Register.

    American Journal of Sports Medicine · Aug 2026 · PubMed

    Concomitant MCL injury did not increase ACL revision risk but reduced sport/recreation outcomes; bone-patellar tendon-bone autograft showed lower revision risk than hamstring graft in this population.

  30. Knee Synovial Fluid Biomarker Type and Concentration With Long-Term Outcomes After ACL Reconstruction With Concomitant Meniscal Injury.

    American Journal of Sports Medicine · Aug 2026 · PubMed

    Synovial inflammatory phenotypes at ACL reconstruction with meniscal injury predict baseline severity and differential recovery patterns; phenotype-dependent biomarker associations guide prognostication.

Landmark papers

  1. Biomechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Ligament Injury Risk in Female Athletes: A Prospective Study

    American Journal of Sports Medicine · 2005 · cited 3,560 times · PubMed

    Prospective biomechanical testing showed increased knee valgus angle and abduction moment during landing strongly predicted future ACL injury risk in female athletes, supporting targeted neuromuscular training.

  2. The Long-term Consequence of Anterior Cruciate Ligament and Meniscus Injuries

    American Journal of Sports Medicine · 2007 · cited 2,299 times · PubMed

    This review of ACL and meniscus injuries addresses their long-term link to osteoarthritis, the pathogenic mechanisms involved, and the lack of evidence that surgical repair prevents this progression.

  3. Noncontact Anterior Cruciate Ligament Injuries: Risk Factors and Prevention Strategies

    Journal of the American Academy of Orthopaedic Surgeons · 2000 · cited 1,452 times · PubMed

    Reviews environmental, anatomic, hormonal, and biomechanical risk factors for noncontact ACL injuries, finding neuromuscular training may reduce risk in female athletes though more research is needed.

  4. Biomechanical Measures during Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury after Anterior Cruciate Ligament Reconstruction and Return to Sport

    American Journal of Sports Medicine · 2010 · cited 1,352 times · PubMed

    Post-ACLR landing biomechanics (frontal-plane knee valgus, hip rotation moment, knee extensor asymmetry) and postural stability deficits strongly predicted second ACL injury after return to sport.

  5. Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction

    American Journal of Sports Medicine · 2016 · cited 1,316 times · PubMed

    This meta-analysis found nearly 1 in 4 young athletes returning to sport after ACL reconstruction sustain a second ACL injury, highlighting major reinjury risk from youth and return-to-play activity.

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