{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T18:05:36Z","timestamp":1773597936437,"version":"3.50.1"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"10","funder":[{"name":"National Institutes of Health (NIH) National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Musculoskeletal","award":["R01AR055563"],"award-info":[{"award-number":["R01AR055563"]}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","award":["UL1 TR002377"],"award-info":[{"award-number":["UL1 TR002377"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Introduction\u2003Second anterior cruciate ligament (SACL) injuries are a devastating complication following return to sport (RTS). Appropriate and safe RTS criteria that reduce the risk of SACL injuries are needed. The goal of this study was to investigate the relationship between functional and isokinetic testing at 6 months following primary ACL reconstruction (ACLR) as risk factors for SACL injuries.<\/jats:p><jats:p>Methods\u2003Patients with primary ACLR from 1990 to 2010 were identified. Those with 6-month postoperative functional and isokinetic testing and a minimum of 2-year follow-up were included. Functional testing included vertical jump, single-leg hop, and single-leg triple hop. Isokinetic testing included concentric quadriceps and hamstrings (HSs) strength at 60 and 180\u2009degree\/s speeds. Statistical analysis evaluated the significance of the various tests between those with and without a secondary tear.<\/jats:p><jats:p>Results\u2003In total, 344 patients with a mean age of 26.0\u2009\u00b1\u20099.8 years at an average time of 9.1\u2009\u00b1\u20093.5 years of follow-up were analyzed. Fifty-nine patients (17%) experienced SACL injuries at an average time of 4.8 years following ACLR with 34 (58%) ipsilateral graft ruptures and 25 (43%) contralateral tears. Several isokinetic measures were significantly different between the NO SACL and the SACL groups: quadriceps 60\u2009degree\/s limb symmetry index (LSI) (75 vs. 82% p\u2009=\u20090.01), HS 60\u2009degree\/s LSI (92 vs. 97%, p\u2009=\u20090.04), quadriceps 180\u2009degree\/s involved\/body weight (BW) (41 vs. 47%, p\u2009=\u20090.04), and HS 180\u2009degree\/s involved\/BW (30 vs. 34%, p\u2009=\u20090.04). Patients with involved limb peak quadriceps torque value greater than 65 or 50% of BW (60 and 180\u2009degree\/s) had a 2.2 and 3.1 times higher risk of an SACL injury.<\/jats:p><jats:p>Conclusions\u2003Patients with certain elevated isokinetic scores in the injured limb at 6 months after ACLR experienced a higher rate of subsequent ACL injuries than those who had lower peak torque. Although a quantitative only analysis may not be sufficient to determine RTS criteria, clinicians should caution high-performing patients about the risk of subsequent ACL injury.<\/jats:p><jats:p>Level of Evidence\u2003Cohort study; 3.<\/jats:p>","DOI":"10.1055\/s-0042-1748824","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T23:59:42Z","timestamp":1654905582000},"page":"1060-1068","source":"Crossref","is-referenced-by-count":12,"title":["Are 6-Month Functional and Isokinetic Testing Measures Risk Factors for Second Anterior Cruciate Ligament Injuries at Long-T Follow-Up?"],"prefix":"10.1055","volume":"36","author":[{"given":"Erick M.","family":"Marigi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rena F.","family":"Hale","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher D.","family":"Bernard","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathaniel","family":"Bates","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2281-0018","authenticated-orcid":false,"given":"Michael J.","family":"Stuart","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy E.","family":"Hewett","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron J.","family":"Krych","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,6,10]]},"reference":[{"issue":"04","key":"ref1","first-page":"1011","article-title":"\u201cI never made it to the pros\u2026\u201d Return to sport and becoming an elite athlete after pediatric and adolescent anterior cruciate ligament injury\u2014current evidence and future directions","volume":"26","author":"E Hamrin Senorski","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"43","DOI":"10.2519\/jospt.2019.8190","article-title":"The association between passing return-to-sport criteria and second anterior cruciate ligament injury risk: a systematic review with meta-analysis","volume":"49","author":"J M Losciale","year":"2019","journal-title":"J Orthop Sports Phys Ther"},{"issue":"08","key":"ref3","doi-asserted-by":"crossref","first-page":"2325967117724196","DOI":"10.1177\/2325967117724196","article-title":"Incidence of second anterior cruciate ligament tears and identification of associated risk factors from 2001 to 2010 using a geographic database","volume":"5","author":"N D Schilaty","year":"2017","journal-title":"Orthop J Sports Med"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"2325967118810775","DOI":"10.1177\/2325967118810775","article-title":"Poor performance on single-legged hop tests associated with development of posttraumatic knee osteoarthritis after anterior cruciate ligament injury","volume":"6","author":"E Wellsandt","year":"2018","journal-title":"Orthop J Sports 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