Knee Surgery Sports Traumatology Arthroscopy · IF 3.3 · September 11, 2026 · LoE III
The role of generalised joint Laxity in anterior cruciate ligament reconstruction: A systematic review and meta‐analysis
Pierangelo Zà, Giuseppe Francesco Papalia, Clemente Caria, Marco Minelli, Susanna Basciani, Sebastiano Vasta — IRCCS Ospedale San Raffaele
This meta-analysis pooled 13 studies (3905 patients) comparing outcomes of ACL reconstruction in patients with generalised joint laxity (GJL) versus without. Patients with GJL had significantly lower IKDC and Lysholm scores and higher rates of positive Lachman and pivot shift tests, but the difference in graft failure rate (9.2% vs 6.1%) was not statistically significant (OR 3.15, p=0.07).
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersSurgeons often wonder whether hyperlax patients need a different graft or added lateral procedure, and this review shows the evidence for worse clinical outcomes is inconsistent and failure rates are not statistically different.
Conclusion strengthInconclusive
Two or more critical methodological failures for a review.
Presenting this at rounds? Start here
- ?Should surgeons routinely add a lateral extra-articular tenodesis or ALL reconstruction in patients with generalised joint laxity given the nonsignificant failure rate difference?
- ?Does the finding of greater residual laxity but not worse failure rates change how you counsel hyperlax patients preoperatively about expected outcomes?