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Among these, 156\u00a0met the inclusion criteria. L\u2010ATT and M\u2010ATT were measured using preoperative weight\u2010bearing magnetic resonance imaging (MRI), and the differences between L\u2010ATT and M\u2010ATT were calculated. Thirty\u2010five patients who demonstrated excessive differences in L\u2010ATT and M\u2010ATT (&gt;\u20096.0\u00a0mm) were regarded as asymmetric (study group), and 36 patients with minimal or no differences in L\u2010ATT and M\u2010ATT (&lt;\u20093.0\u00a0mm) were allocated to the control group. Demographic data, grade of the pivot\u2010shift test, integrality of LMPH, and medial meniscus posterior horn (MMPH) were compared between the groups. Moreover, predictors of high\u2010grade pivot\u2010shift phenomenon, including asymmetry of L\u2010ATT and M\u2010ATT, integrity of LMPH and MMPH, time from injury to surgery, sex, age, and body mass index (BMI) were assessed using multivariable logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The difference between L\u2010ATT and M\u2010ATT in the study group was significantly higher than that in the control group (mean\u2009\u00b1\u2009SD: 8.4\u2009\u00b1\u20092.1\u00a0mm vs. 1.5\u2009\u00b1\u20091.0\u00a0mm, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). A higher proportion of patients with high\u2010grade pivot\u2010shift phenomenon (2\u2009+\u2009and 3\u2009+) and LMPH tears were identified in the study group (high\u2010grade pivot\u2010shift phenomenon: 25\/35 vs. 13\/36, <jats:italic>P<\/jats:italic>\u2009=\u20090.003; LMPH tears: 18\/35 vs. 5\/36, <jats:italic>P<\/jats:italic>\u2009=\u20090.001). Additionally, asymmetry of L\u2010ATT, M\u2010ATT (odds ratio 5.8; 95% CI 1.7\u201319.8; <jats:italic>P<\/jats:italic>\u2009=\u20090.005), and LMPH tears (odds ratio 3.8; 95% CI 1.3\u201311.6; <jats:italic>P<\/jats:italic>\u2009=\u20090.018) were found to be good predictors of the high\u2010grade pivot\u2010shift phenomenon after ACL injury, whereas MMPH tears, time from injury to surgery, sex, age, and BMI were not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with ACL injury, the high\u2010grade pivot\u2010shift phenomenon is associated with asymmetry between L\u2010ATT and M\u2010ATT, and LMPH tears.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-06972-x","type":"journal-article","created":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T00:03:27Z","timestamp":1650672207000},"page":"3700-3707","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["High\u2010grade pivot\u2010shift phenomenon after anterior cruciate ligament injury is associated with asymmetry of lateral and medial compartment anterior tibial translation and lateral meniscus posterior horn tears"],"prefix":"10.1002","volume":"30","author":[{"given":"Qian\u2010Kun","family":"Ni","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Sports Medicine Department Zhengzhou Orthopedics Hospital No.58, Long Hai Middle Road, Er Qi District Zhengzhou Henan Province 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Liu","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Sports Medicine Department Zhengzhou Orthopedics Hospital No.58, Long Hai Middle Road, Er Qi District Zhengzhou Henan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Sports Medicine Department Beijing Jishuitan Hospital No. 31, Xin Jie Kou East Street, Xi Cheng District Beijing 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