Izvorni znanstveni članak
https://doi.org/10.69589/hsv.41.1.2
The relationship between hypermobility and anterior cruciate ligament injury in sports: A systematic review
Igor Jukić
; Sveučilište u Zagrebu Kineziološki fakultet
Željko Jeleč
; Specijalna bolnica Sv. Katarina, Zagreb
Luka Milanović
; Sveučilište u Zagrebu Kineziološki fakultet
Marin Dadić
; Sveučilište u Zagrebu Kineziološki fakultet
Stjepan Štimac
; Sveučilište u Zagrebu Kineziološki fakultet,
Sažetak
Anterior cruciate ligament (ACL) injuries rank among the most serious and frequently encountered injuries in competitive sport. Beyond prolonged absence from training and competition, they are associated with measurable declines in athletic performance and carry a substantial risk of premature knee osteoarthritis. Despite the considerable volume of research conducted in this area, intrinsic risk factors remain poorly defined. Joint hypermobility and generalized ligamentous laxity have received growing attention as factors potentially contributing to both primary injury susceptibility and outcomes following surgical reconstruction. This systematic review aimed to examine and critically appraise available evidence regarding the relationship between joint hypermobility and three key outcomes: primary ACL injury risk, second ACL injury occurring after reconstruction, and clinical results following ACL reconstruction (ACLR). The literature search was carried out across three electronic databases: PubMed/MEDLINE, EMBASE, and the Cochrane Library. Studies were considered eligible if they examined generalized joint hypermobility, ligamentous laxity, or knee hyperextension in relation to ACL injury or outcomes following ACLR, encompassing cohort studies, case–control studies, registry-based analyses, biomechanical studies, and systematic reviews. Generalized joint hypermobility and knee hyperextension appear to be associated with a greater likelihood of primary ACL injury, though this relationship is not uniform across studies and has not been reliably confirmed in large prospective cohorts of elite athletes. The clearest and most reproducible association emerges in the context of secondary ACL injury and graft failure after reconstruction, where hypermobile individuals tend to show greater postoperative laxity and higher rates of graft failure. Findings on patientreported outcomes, however, are less consistent. Available biomechanical data further suggest that hypermobile athletes exhibit altered landing mechanics that may increase ACL loading. Among intrinsic risk factors, joint hypermobility holds particular clinical relevance, especially in relation to secondary ACL injury and unfavourable outcomes after reconstruction. Incorporating hypermobility assessment into routine clinical practice could improve how injury prevention, surgical planning, and return-to-sport decisions are approached.
Ključne riječi
anterior cruciate ligament, joint hypermobility, ACL injury, Beighton score, ACL reconstruction
Hrčak ID:
348756
URI
Datum izdavanja:
30.6.2026.
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