Indian journal of orthopaedics
February 2, 2026 · via Europe PMC
Changes in Coronal Plane Alignment and Functional Outcomes Following Primary ACL Reconstruction: A Retrospective Cohort Analysis.
İnce M, Oğur HU, Çiçek H, Seyfettinoğlu F, Pazarcı Ö, Çiçek O.
AI summary — for doctors, generated from the abstract only
Single-bundle hamstring ACL reconstruction did not change coronal alignment at 5 years, but residual varus was linked to worse function.
What was studied
A retrospective cohort of 100 ACL reconstructions with long-leg radiographs at a mean of 60 months, comparing operated and contralateral limbs.
Key findings
- HKA, mLDFA, MPTA, JLCA and MAD did not differ between sides
- Varus mechanical axis deviation correlated with lower Tegner-Lysholm scores (r -0.28)
- BMI correlated with varus deviation (r 0.32)
Clinical relevance
ACL reconstruction does not appear to cause progressive deformity.
Who should care
Limitations
Retrospective with modest correlations and no preoperative alignment baseline.
Assess limb alignment in patients with poor function after ACL reconstruction.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
The long‑term impact of primary anterior cruciate ligament (ACL) reconstruction on coronal limb alignment is still debated. We investigated mid‑term mechanical axis changes and their clinical correlates after single‑bundle hamstring ACL reconstruction.
Methods
This retrospective cohort comprised 100 consecutive patients who underwent primary ACL reconstruction between 2013 and 2018. Standing long‑leg radiographs obtained at a mean 60 ± 14 months were used to measure hip-knee-ankle (HKA) angle, mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), joint‑line convergence angle (JLCA) and mechanical axis deviation (MAD) in the operated and contralateral limbs. Functional outcome was assessed using the Tegner-Lysholm Knee Score. Paired t tests compared limbs, and Spearman correlations examined associations with clinical parameters (α = 0.05).
Results
No significant differences were detected between reconstructed and contralateral knees for HKA (177.3° ± 3.3 vs 177.7° ± 3.1), mLDFA (87.6° ± 2.5 vs 87.4° ± 2.2), MPTA (85.6° ± 2.3 vs 85.6° ± 2.2), JLCA (1.11° ± 1.8 vs 0.72° ± 1.17) or MAD (5.96 ± 18.1 mm vs 3.68 ± 8.9 mm) (all p > 0.05). Varus MAD correlated with lower Tegner-Lysholm scores (r = -0.28, p = 0.01). Body‑mass index showed a moderate positive correlation with varus deviation (r = 0.32, p = 0.02). Meniscal lesions (n = 43) had no effect on alignment parameters.
Conclusions
Primary ACL reconstruction maintained coronal alignment at 5‑year follow‑up. Nonetheless, varus deviation adversely affected functional outcomes, underscoring the importance of addressing postoperative malalignment.Trial Registration Not applicable.
Graphical abstract
The vs partial meniscectomy 100 primary ACL-reconstructed knees tracked to a 5-year follow-up. Mean hip-knee-ankle varus angles remained stable (1.5° → 1.7°, p = 0.28), confirming no progressive coronal deformity. Patients with residual varus > 3° showed lower Tegner-Lysholm scores, highlighting the functional impact of alignment.
DOI
10.1007/s43465-026-01699-0
PMID
42824328
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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