Does It Really Matter? The Pessimistic Interpretation of Contralateral Anterior Laxity as a Predictor of ACL Reconstruction Outcomes

Abstract

Kim et al. investigated the role of contralateral knee laxity as a predictor of clinical outcomes following anterior cruciate ligament (ACL) reconstruction. The authors should be applauded for this pursuit and attempt to investigate a previously unexamined predictor of these outcomes. The reader should not, however, overlook the fact that the significant differences, on which the conclusions hinge, are in fact clinically insignificant and the authors’ conclusions are therefore grossly overstated. Many authors have explored the role of nonmodifiable patient-specific risk factors such as sex, age, excessive posterior tibial slope, and generalized ligamentous laxity as predisposing factors for ACL injury. Myer et al.1 determined that knee hyperextension and side-to-side differences in anterior-posterior laxity resulted in fivefold and fourfold increases in the odds of ACL injury, respectively, in a large prospective cohort of female soccer and basketball players. The authors of another study2 found that generalized ligamentous knee laxity and knee hyperextension were more common among those who sustained an ACL injury compared with controls. Uhorchak et al.3 determined that …