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Advancements in Anterior Cruciate Ligament Injury: From Diagnosis to the Return-to-Sports: 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Sports Medicine".

Deadline for manuscript submissions: 28 November 2025 | Viewed by 734

Special Issue Editors

Dr. Alexandre Hardy

E-Mail Website
Guest Editor
Clinique du Sport, Universidad de París V Descartes, 75005 Paris, France
Interests: sports medicine; anterior cruciate ligament reconstruction (ACLR); timing of ACLR; ramp lesion; meniscal lesion; lateral extraarticular procedure; hamstring surgery; ankle reconstruction
Special Issues, Collections and Topics in MDPI journals
Dr. Nicolas Bouguennec

E-Mail Website
Guest Editor
Clinique du Sport de Bordeaux-Mérignac, 33700 Mérignac, France
Interests: sports medicine; anterior cruciate ligament reconstruction (ACLR); timing of ACLR; ramp lesion; meniscal lesion; lateral extraarticular procedure; hamstring surgery; ankle reconstruction
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are excited to announce the release of the second volume of the Special Issue titled 'Advancements in Anterior Cruciate Ligament Injury: From Diagnosis to the Return-to-Sports'. We also invite you to visit our website to access the first volume of this Special Issue, available at the following link: https://www.mdpi.com/journal/jcm/special_issues/D0QMRA6PD4. 

Anterior cruciate ligament (ACL) reconstruction remains a critical aspect of orthopedic sport medicine, with the ACL being the most reconstructed ligament in the body. The evolution of ACL reconstruction has seen remarkable advancements from traditional techniques to more anatomically aligned and biomechanically sound procedures, enhancing patient outcomes and reducing recovery times.

Furthermore, the integration of techniques such as the lateral extra-articular procedure (LEAP) has further tailored the approach to patients with high rotational instability, showing promising results in reducing re-rupture rates. Despite these advancements, challenges remain, such as the ideal indications for LEAPs; the long-term impact of these procedures, such as osteoarthritis and stiffness; the effective management of complex multi-ligament injuries; and optimizing the timing and techniques of ACL reconstruction. New techniques and materials in ACL reconstruction are continually evolving, from biologic augmentations to novel imaging and post-operative protocols. The aim is to ensure the highest return-to-sport rate, at the same pre-injury level, while minimizing the risk of re-rupture.

To enable this, we welcome the submission of original research articles, reviews, cohort studies, and meta-analyses that will contribute to our understanding of ACL injuries from diagnosis to the return to sports.

Dr. Alexandre Hardy
Dr. Nicolas Bouguennec
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • anterior cruciate ligament reconstruction (ACLR)
  • timing of ACLR
  • ramp lesion
  • meniscal lesion
  • lateral extra-articular procedure

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Related Special Issue

Published Papers (2 papers)

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Research

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14 pages, 2122 KiB  
Article
Changes to the Intercondylar Ligaments of the Knee in Different Stages of Osteoarthritis—A Retrospective Cross-Sectional Study
by Elisabeth Mandler, Franz Kainberger and Lena Hirtler
J. Clin. Med. 2025, 14(13), 4513; https://doi.org/10.3390/jcm14134513 - 25 Jun 2025
Viewed by 358
Abstract
Background: The intercondylar notch (IN) houses the central ligaments of the knee joint, namely the anterior and posterior cruciate ligaments (ACL and PCL) as well as the anterior and posterior meniscofemoral ligaments (aMFL and pMFL). As not only the available intercondylar space directly [...] Read more.
Background: The intercondylar notch (IN) houses the central ligaments of the knee joint, namely the anterior and posterior cruciate ligaments (ACL and PCL) as well as the anterior and posterior meniscofemoral ligaments (aMFL and pMFL). As not only the available intercondylar space directly influences the encased ligaments, but also the ligaments themselves may influence each other, the purpose of this study was to evaluate the influence of osteoarthritis on central ligament morphology. Methods: Imaging data from the osteoarthritis initiative was used to assess 415 randomly selected patients, equally distributed across five groups based on osteoarthritis severity using the Kellgren and Lawrence classification. MRI scans were used to measure ligament structures in the coronal, axial and sagittal planes. The ACL was evaluated and classified into healthy, pathologic and ruptured. The relationship between osteoarthritis severity and the shape of the IN (A-shape, inverse-U-shape and Ω-shape) was analyzed in relation to ligament morphometrics and ACL condition. Results: The morphology of the ligaments is directly influenced by the development of osteoarthritis. In particular, the Ω-shape, which is associated with severe-grade osteoarthritis, is a risk factor for the development of ACL rupture (p < 0.001). But also, the condition of the ACL influenced the morphometrics of the posterior ligaments, and the PCL as well as the MFLs influenced each other. Conclusions: Statistically significant morphological changes to the encased ligaments in the intercondylar space in osteoarthritis were reported. In particular, the ACL shows a higher risk for pathological changes during ongoing joint degeneration due to osteoarthritis. The other evaluated ligaments—MFLs and PCL—are influenced by the condition of the osseous structures and the shape of the IN as well as by the condition and continuity of the ACL. Full article
(This article belongs to the Special Issue Advancements in Anterior Cruciate Ligament Injury: From Diagnosis to the Return-to-Sports: 2nd Edition)
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Review

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13 pages, 564 KiB  
Review
Lack of Gender-Disaggregated Data for the Psychological Impact of ACL Injury on Adolescents
by David Holdroyd, Benjamin Gompels, Ilias Epanomeritakis, Alexandra Macmillan, Simone Castagno, Hans Johnson and Stephen McDonnell
J. Clin. Med. 2025, 14(14), 4885; https://doi.org/10.3390/jcm14144885 - 9 Jul 2025
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Abstract
Background: This literature review examines the prevalence and severity of depression and anxiety symptoms in adolescents following ACL injury, with a focus on gender-disaggregated data. Methods: An electronic search was conducted across databases, including Ovid MEDLINE (R), PUBMED, and the Cochrane [...] Read more.
Background: This literature review examines the prevalence and severity of depression and anxiety symptoms in adolescents following ACL injury, with a focus on gender-disaggregated data. Methods: An electronic search was conducted across databases, including Ovid MEDLINE (R), PUBMED, and the Cochrane Library, covering articles from 1964 to 13 February 2024. Primary search terms were “ACL,” “depression,” “anxiety,” and “adolescent,” expanded using medical subject headings (MeSH). Manual searches of the references supplemented the database search. Inclusion criteria included studies on depression or anxiety post-ACL injury in adolescents. The exclusion criteria were studies without adolescent participants or those focusing exclusively on one sex. Results: The search identified 62 studies, of which 5 were ultimately selected for comprehensive analysis. Four studies reported on depression using various scales, and three measured anxiety symptoms. No studies provided gender-disaggregated data. One study found no significant difference in depression scores between adolescent and adult patients. Another study noted that socioeconomic disadvantage correlated with increased depressive and anxiety symptoms post-surgery. An additional study highlighted a significant increase in depression scores from pre- to post-injury among ACL-injured participants compared to uninjured controls. Conclusions: Our understanding of the psychological consequences of ACL rupture on female adolescent patients is incomplete. Given the high incidence of ACL injuries in this patient group and their potential psychological vulnerability, improving the evidence base in this area could address a previously neglected aspect of care, with positive impacts on returning to sport and quality of life. Future studies of high methodological quality are needed to address this gap in the literature. Full article
(This article belongs to the Special Issue Advancements in Anterior Cruciate Ligament Injury: From Diagnosis to the Return-to-Sports: 2nd Edition)
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