{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T23:58:34Z","timestamp":1778111914267,"version":"3.51.4"},"reference-count":65,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T00:00:00Z","timestamp":1693094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The development of post-traumatic osteoarthrosis after tibial plateau fracture (TPF) is multifactorial and can only be partially influenced by surgical treatment. There is no standardized method for assessing pre- and postoperative knee joint laxity. Data on the incidence of postoperative laxity after TPF are limited. The purpose of this study was to quantify postoperative laxity of the knee joint after TPF. Fifty-four patients (mean age 51 \u00b1 11.9 years) were included in this study. There was a significant increase in anterior\u2013posterior translation in 78.0% and internal rotation in 78.9% in the injured knee when compared to the healthy knee. Simple fractures showed no significant difference in laxity compared to complex fractures. When preoperative ligament damage and\/or meniscal lesions were present and surgically treated by refixation and\/or bracing, patients showed higher instability when compared to patients without preoperative ligament and\/or meniscal damage. Patients with surgically treated TPF demonstrate measurable knee joint laxity at a minimum of 1 year postoperatively. Fracture types have no influence on postoperative laxity. This emphasizes the importance of recognizing TPF as a multifaceted injury involving both complex fractures and damage to multiple ligaments and soft tissue structures, which may require further surgical intervention after osteosynthesis.<\/jats:p>","DOI":"10.3390\/jcm12175580","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T05:46:47Z","timestamp":1693201607000},"page":"5580","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["High Prevalence of Persistent Measurable Postoperative Knee Joint Laxity in Patients with Tibial Plateau Fractures Treated by Open Reduction and Internal Fixation (ORIF)"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7024-3620","authenticated-orcid":false,"given":"Markus","family":"Bormann","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0501-5466","authenticated-orcid":false,"given":"Claas","family":"Neidlein","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels","family":"Neidlein","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Ehrl","sequence":"additional","affiliation":[{"name":"Department of Hand, Plastic and Aesthetic Surgery, LMU Munich, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1877-7673","authenticated-orcid":false,"given":"Maximilian","family":"J\u00f6rgens","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6630-6406","authenticated-orcid":false,"given":"Daniel P.","family":"Berthold","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"B\u00f6cker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boris Michael","family":"Holzapfel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5529-1632","authenticated-orcid":false,"given":"Julian","family":"F\u00fcrmetz","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Trauma Center Murnau, 82418 Murnau am Staffelsee, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1016\/j.injury.2018.09.008","article-title":"Epidemiology and incidence of tibia fractures in the Swedish Fracture Register","volume":"49","author":"Wennergren","year":"2018","journal-title":"Injury"},{"key":"ref_2","first-page":"665","article-title":"The incidence of fractures among the adult population of Germany","volume":"118","author":"Rupp","year":"2021","journal-title":"Deutsch. \u00c4rztebl. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s00068-022-02076-w","article-title":"Changing patterns in the epidemiology of tibial plateau fractures: A 10-year review at a level-I trauma center","volume":"49","author":"Bormann","year":"2022","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e780","DOI":"10.3928\/01477447-20150902-55","article-title":"Population-Based Epidemiology of Tibial Plateau Fractures","volume":"38","author":"Elsoe","year":"2015","journal-title":"Orthopedics"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3643","DOI":"10.1007\/s00068-020-01525-8","article-title":"Tibial plateau fractures in Belgium: Epidemiology, financial burden and costs curbing strategies","volume":"48","author":"Herteleer","year":"2022","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1055\/s-0038-1627464","article-title":"The Impact of Computed Tomography on Decision Making in Tibial Plateau Fractures","volume":"31","author":"Castiglia","year":"2018","journal-title":"J. Knee Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1016\/j.injury.2018.11.010","article-title":"Revisiting the Schatzker classification of tibial plateau fractures","volume":"49","author":"Kfuri","year":"2018","journal-title":"Injury"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s00113-022-01165-0","article-title":"Wandel in der Behandlung der Tibiakopffraktur","volume":"125","author":"Krause","year":"2022","journal-title":"Die Unfallchirurgie"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.injury.2018.01.025","article-title":"A systematic literature review of tibial plateau fractures: What classifications are used and how reliable and useful are they?","volume":"49","author":"Millar","year":"2018","journal-title":"Injury"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.knee.2015.10.004","article-title":"Outcomes after Total Knee Arthroplasty for post-traumatic arthritis","volume":"22","author":"Bala","year":"2015","journal-title":"Knee"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.joca.2018.12.020","article-title":"Tibial plateau fractures are associated with a long-lasting increased risk of total knee arthroplasty a matched cohort study of 7,950 tibial plateau fractures","volume":"27","author":"Elsoe","year":"2019","journal-title":"Osteoarthr. Cartil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1007\/s00590-021-03083-0","article-title":"Characteristics of patients requiring early total knee replacement after surgically treated lateral tibial plateau fractures\u2014A comparative cohort study","volume":"32","author":"Hansen","year":"2022","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1016\/j.arth.2016.02.001","article-title":"Total Knee Arthroplasty for Posttraumatic Osteoarthritis: Is it Time for a New Classification?","volume":"31","author":"Kester","year":"2016","journal-title":"J. Arthroplast."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1055\/s-0039-1683893","article-title":"Age-Related Variances in Patients with Tibial Plateau Fractures","volume":"33","author":"Oladeji","year":"2020","journal-title":"J. Knee Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"584","DOI":"10.5312\/wjo.v7.i9.584","article-title":"Total knee arthroplasty for treatment of post-traumatic arthritis: Systematic review","volume":"7","author":"Saleh","year":"2016","journal-title":"World J. Orthop."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1016\/j.arth.2020.03.041","article-title":"Five-Year Risk of Conversion to Total Knee Arthroplasty After Operatively Treated Periarticular Knee Fractures in Patients Over 40 Years of Age","volume":"35","author":"Scott","year":"2020","journal-title":"J. Arthroplast."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"144","DOI":"10.2106\/JBJS.L.01691","article-title":"Risk of Total Knee Arthroplasty After Operatively Treated Tibial Plateau Fracture: A Matched-Population-Based Cohort Study","volume":"96","author":"Wasserstein","year":"2014","journal-title":"J. Bone Jt. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.asjsur.2016.11.011","article-title":"Comminuted intraarticular fractures of the tibial plateau lead to posttraumatic osteoarthritis of the knee: Current treatment review","volume":"41","author":"Aurich","year":"2018","journal-title":"Asian J. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.arth.2015.07.022","article-title":"Posttraumatic Total Knee Arthroplasty Continues to Have Worse Outcome Than Total Knee Arthroplasty for Osteoarthritis","volume":"31","author":"Houdek","year":"2016","journal-title":"J. Arthroplast."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"205031212096531","DOI":"10.1177\/2050312120965316","article-title":"Physiotherapy after tibial plateau fracture fixation: A systematic review of the literature","volume":"8","author":"Iliopoulos","year":"2020","journal-title":"SAGE Open Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.ocl.2019.06.002","article-title":"Posttraumatic Arthritis After Intra-Articular Distal Femur and Proximal Tibia Fractures","volume":"50","author":"Davis","year":"2019","journal-title":"Orthop. Clin. N. Am."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"20","DOI":"10.5435\/JAAOS-22-01-20","article-title":"Pathogenesis and Prevention of Posttraumatic Osteoarthritis After Intra-articular Fracture","volume":"22","author":"Schenker","year":"2014","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_23","first-page":"57","article-title":"Post-traumatic osteoarthritis following ACL injury","volume":"22","author":"Wang","year":"2020","journal-title":"Thromb. Haemost."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s12306-017-0514-8","article-title":"A review of the management of tibial plateau fractures","volume":"102","author":"Mthethwa","year":"2018","journal-title":"Musculoskelet. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1097\/BOT.0000000000000762","article-title":"Outcome After Tibial Plateau Fracture: How Important Is Restoration of Articular Congruity?","volume":"31","author":"Singleton","year":"2017","journal-title":"J. Orthop. Trauma"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.ocl.2020.06.003","article-title":"Soft Tissue Injury Considerations in the Treatment of Tibial Plateau Fractures","volume":"51","author":"Adams","year":"2020","journal-title":"Orthop. Clin. N. Am."},{"key":"ref_27","unstructured":"Berninger, M.T., Sch\u00fcttrumpf, J., and Krause, M. (2022). Tibiakopffrakturen, Deutsche Gesellschaft f\u00fcr Orthop\u00e4die und Unfallchirurgie e.V. (DGOU). Version 1.0 (29.10.2021)."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"232596712198931","DOI":"10.1177\/2325967121989312","article-title":"Lower Failure Rates and Improved Patient Outcome Due to Reconstruction of the MCL and Revision ACL Reconstruction in Chronic Medial Knee Instability","volume":"9","author":"Alm","year":"2021","journal-title":"Orthop. J. Sports Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1007\/s00167-011-1860-y","article-title":"Pivot shift as an outcome measure for ACL reconstruction: A systematic review","volume":"20","author":"Ayeni","year":"2012","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2631","DOI":"10.1177\/03635465211025003","article-title":"Neither Residual Anterior Knee Laxity Up to 6 mm nor a Pivot Glide Predict Patient-Reported Outcome Scores or Subsequent Knee Surgery between 2 and 6 Years After ACL Reconstruction","volume":"49","author":"Magnussen","year":"2021","journal-title":"Am. J. Sports Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1016\/j.arthro.2011.02.034","article-title":"Validation of a Measurement Device for Instrumented Quantification of Anterior Translation and Rotational Assessment of the Knee","volume":"27","author":"Mayr","year":"2011","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1177\/0363546508323746","article-title":"Current Concepts in Instrumented Knee-Laxity Testing","volume":"37","author":"Pugh","year":"2009","journal-title":"Am. J. Sports Med."},{"key":"ref_33","first-page":"94","article-title":"The tibial plateau fracture: The Toronto experience 1968\u20131975","volume":"138","author":"Schatzker","year":"1979","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/00003086-198105000-00015","article-title":"Fracture-Dislocation of the knee","volume":"156","author":"Moore","year":"1981","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1177\/0363546504267050","article-title":"A New Mechanical Testing Device for Measuring Anteroposterior Knee Laxity","volume":"32","author":"Schuster","year":"2004","journal-title":"Am. J. Sports Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1302\/2058-5241.6.200096","article-title":"Posterolateral corner knee injuries: A narrative review","volume":"6","author":"Figueroa","year":"2021","journal-title":"EFORT Open Rev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1055\/s-0030-1268694","article-title":"Soft Tissue Injury of the Knee after Tibial Plateau Fractures","volume":"23","author":"Stannard","year":"2010","journal-title":"J. Knee Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/j.knee.2019.02.017","article-title":"The anatomy of the anterolateral structures of the knee\u2014A histologic and macroscopic approach","volume":"26","author":"Brockmeyer","year":"2019","journal-title":"Knee"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1007\/s12178-019-09587-x","article-title":"Anterior Cruciate Ligament Injury and the Anterolateral Complex of the Knee\u2014Importance in Rotatory Knee Instability?","volume":"12","author":"Golan","year":"2019","journal-title":"Curr. Rev. Musculoskelet. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2909","DOI":"10.1007\/s00167-015-3616-6","article-title":"Anterolateral rotatory instability of the knee","volume":"23","author":"Guenther","year":"2015","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1007\/s00167-017-4449-2","article-title":"The anterolateral complex of the knee: A pictorial essay","volume":"25","author":"Herbst","year":"2017","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.csm.2017.07.004","article-title":"Biomechanics of the Anterolateral Structures of the Knee","volume":"37","author":"Kittl","year":"2018","journal-title":"Clin. Sports Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"261","DOI":"10.5435\/JAAOS-D-16-00758","article-title":"The Anterolateral Complex and Anterolateral Ligament of the Knee","volume":"26","author":"Musahl","year":"2018","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s10195-017-0449-8","article-title":"Anterolateral Ligament Expert Group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament-deficient knee","volume":"18","author":"Daggett","year":"2017","journal-title":"J. Orthop. Traumatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1177\/036354658601400108","article-title":"The anatomy of the iliopatellar band and iliotibial tract","volume":"14","author":"Terry","year":"1986","journal-title":"Am. J. Sports Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1055\/a-0785-1655","article-title":"Chirurgische Zug\u00e4nge zum Tibiakopf","volume":"34","author":"Hissnauer","year":"2019","journal-title":"OP-J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1055\/s-0033-1363519","article-title":"Surgical Approaches for Tibial Plateau Fractures","volume":"27","author":"Maclean","year":"2013","journal-title":"J. Knee Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3917","DOI":"10.1007\/s00402-021-04298-w","article-title":"Tibial slope in the posterolateral quadrant with and without ACL injury","volume":"142","author":"Korthaus","year":"2021","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e339","DOI":"10.1097\/BOT.0000000000001237","article-title":"Risk Factors for Knee Stiffness Surgery After Tibial Plateau Fracture Fixation","volume":"32","author":"Reahl","year":"2018","journal-title":"J. Orthop. Trauma"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1302\/0301-620X.97B1.34195","article-title":"Arthrofibrosis of the knee following a fracture of the tibial plateau","volume":"97","author":"Haller","year":"2015","journal-title":"Bone Jt. J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1055\/s-0040-1718679","article-title":"Knee Arthrofibrosis following Tibial Plateau Fracture Treated with Arthroscopic Lysis of Adhesions with Manipulation","volume":"35","author":"Middleton","year":"2022","journal-title":"J. Knee Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1016\/j.injury.2017.10.008","article-title":"Posterolateral corner injuries: Epidemiology, anatomy, biomechanics and diagnosis","volume":"49","author":"Nannaparaju","year":"2018","journal-title":"Injury"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1177\/0363546515617454","article-title":"Posteromedial Meniscocapsular Lesions Increase Tibiofemoral Joint Laxity with Anterior Cruciate Ligament Deficiency, and Their Repair Reduces Laxity","volume":"44","author":"Stephen","year":"2016","journal-title":"Am. J. Sports Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2839","DOI":"10.1007\/s00402-021-04269-1","article-title":"Laxity measurement of internal knee rotation after primary anterior cruciate ligament rupture versus rerupture","volume":"142","author":"Mayr","year":"2021","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.clinbiomech.2018.01.019","article-title":"The influence of internal and external tibial rotation offsets on knee joint and ligament biomechanics during simulated athletic tasks","volume":"52","author":"Bates","year":"2018","journal-title":"Clin. Biomech."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.clinbiomech.2015.11.022","article-title":"Tibial rotation influences anterior knee stability\u2014A robot-aided in-vitro study","volume":"32","author":"Lorenz","year":"2016","journal-title":"Clin. Biomech."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"944","DOI":"10.2106\/JBJS.D.02876","article-title":"A Sixteen-Year Follow-up of Three Operative Techniques for the Treatment of Acute Ruptures of the Anterior Cruciate Ligament","volume":"88","author":"Drogset","year":"2006","journal-title":"J. Bone Jt. Surg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1177\/0363546518825255","article-title":"ACL Repair with Suture Ligament Augmentation Is Associated with a High Failure Rate Among Adolescent Patients","volume":"47","author":"Gagliardi","year":"2019","journal-title":"Am. J. Sports Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2710","DOI":"10.1007\/s00167-018-5317-4","article-title":"Management of acute knee dislocations: Anatomic repair and ligament bracing as a new treatment option\u2014Results of a multicentre study","volume":"27","author":"Heitmann","year":"2019","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1007\/s00167-020-05852-6","article-title":"Promising clinical and magnetic resonance imaging results after internal bracing of acute posterior cruciate ligament lesions in multiple injured knees","volume":"28","author":"Otto","year":"2020","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1016\/j.arthro.2015.05.007","article-title":"Primary Repair of the Anterior Cruciate Ligament: A Systematic Review","volume":"31","author":"Taylor","year":"2015","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2821","DOI":"10.1007\/s00167-013-2695-5","article-title":"The effect of thigh muscle activity on anterior knee laxity in the uninjured and anterior cruciate ligament-injured knee","volume":"22","author":"Barcellona","year":"2014","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s40634-020-00246-6","article-title":"Healthy subjects with lax knees use less knee flexion rather than muscle control to limit anterior tibia translation during landing","volume":"7","author":"Keizer","year":"2020","journal-title":"J. Exp. Orthop."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/0021-9290(86)90162-4","article-title":"Effect of muscular activity on valgus\/varus laxity and stiffness of the knee","volume":"19","author":"Olmstead","year":"1986","journal-title":"J. Biomech."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2836","DOI":"10.1177\/0363546512461744","article-title":"Associations between Lower Extremity Muscle Mass and Multiplanar Knee Laxity and Stiffness: A Potential Explanation for Sex Differences in Frontal and Trans-verse Plane Knee Laxity","volume":"40","author":"Shultz","year":"2012","journal-title":"Am. J. Sports Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5580\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:39:56Z","timestamp":1760128796000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5580"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,27]]},"references-count":65,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jcm12175580"],"URL":"https:\/\/doi.org\/10.3390\/jcm12175580","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,27]]}}}