Search Results (224)

Background/Objectives: Serum 25-hydroxyvitamin D (25(OH)D) concentrations are decreased with metabolic syndrome (MetSy), and low serum 25(OH)D concentrations are associated with poor outcomes following anterior cruciate ligament (ACL) reconstruction (ACLR). It is unknown whether serum 25(OH)D concentrations are decreased in patients with MetSy following ACLR. The purpose of this study was to investigate whether serum 25(OH)D concentrations are decreased with MetSy following ACLR. Methods: This retrospective case–control study consisted of patients (≥18 years) who underwent ACLR. MetSy was defined as meeting any three of the five criteria (cases): (1) body mass index ≥ 30 kg/m², (2) triglycerides ≥ 150 mg/dL, (3) HDL < 40 mg/dL in men and <50 mg/dL in women, (4) systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 85 mmHg, or (5) estimated (from hemoglobin A1c% [HbA1c]) fasting glucose ≥ 100 mg/dL. Participants without MetSy (meeting <3 criteria) served as controls. The first blood lipid, HbA1c, and 25(OH)D assessed ≥90 d after ACLR were included in this study. Results: The final analysis consisted of 219 patients (cases (with MetSy), n = 84; controls (without MetSy), n = 135). Serum 25(OH)D was significantly (p < 0.01) decreased (15.8%) in cases (mean [SD]; 25.1 [11.3] ng/mL) compared to controls (29.8 [14.8] ng/mL). An increasing number of MetSy components was associated with a decreased prevalence of vitamin D sufficiency (p < 0.01). Conclusions: We conclude that serum 25(OH)D concentrations are significantly lower with MetSy. These preliminary findings could provide justification for assessing serum 25(OH)D following ACLR in patients with MetSy and assist with risk stratification. Full article

Tendinopathies are a significant challenge in musculoskeletal medicine, with current treatments showing variable efficacy. Electromagnetic transduction therapy (EMTT) has emerged as a promising therapeutic approach, but its biological effects on tendon cells remain largely unexplored. Here, we investigated the effects of EMTT on primary cultured human tenocytes’ behavior and functions in vitro, focusing on cellular responses, senescence-related pathways, and molecular mechanisms. Primary cultures of human tenocytes were established from semitendinosus tendon biopsies of patients undergoing anterior cruciate ligament (ACL) reconstruction (n = 6, males aged 17–37 years). Cells were exposed to EMTT at different intensities (40 and 80 mT) and impulse numbers (1000–10,500). Cell viability (MTT assay), proliferation (Ki67), senescence markers (CDKN2a/INK4a), migration (scratch test), cytoskeleton organization (immunofluorescence), and gene expression (RT-PCR) were analyzed. A 40 mT exposure elicited minimal effects, whereas 80 mT treatments induced significant cellular responses. Repeated 80 mT exposure demonstrated a dual effect: despite a moderate decrease in overall cell vitality, increased Ki67 expression (+7%, p ≤ 0.05) and significant downregulation of senescence marker CDKN2a/INK4a were observed, suggesting potential senolytic-like activity. EMTT significantly enhanced cell migration (p < 0.001) and triggered cytoskeletal remodeling, with amplified stress fiber formation and paxillin redistribution. Molecular analysis revealed upregulation of tenogenic markers (Scleraxis, Tenomodulin) and enhanced Collagen I and III expressions, particularly with treatments at 80 mT, indicating improved matrix remodeling capacity. EMTT significantly promotes tenocyte proliferation, migration, and matrix production, while simultaneously exhibiting senolytic-like effects through downregulation of senescence-associated markers. These results support EMTT as a promising therapeutic approach for the management of tendinopathies through multiple regenerative mechanisms, though further studies are needed to validate these effects in vivo. Full article

Background: The quadriceps femoris (QF) muscle is traditionally described as a four-headed structure (QF4), yet recent anatomical studies have identified significant morphological variations, including accessory heads and complex quadriceps femoris tendon (QFT) layering. These anatomical differences are especially relevant when harvesting the QFT for anterior cruciate ligament (ACL) reconstruction, where graft quality and structure are critical to surgical success. This study aimed to systematically review and quantitatively synthesize available data on QF variants, with a focus on accessory heads and tendon architecture. Methods: This systematic review and meta-analysis followed PRISMA 2020 and Evidence-Based Anatomy Workgroup guidelines. Cadaveric studies reporting QF variants were identified through searches of multiple databases and anatomical journals. Pooled prevalence estimates and mean QFT lengths were calculated using random-effects models. Heterogeneity and publication bias were also assessed. Results: Eighteen studies encompassing 1066 lower limbs met inclusion criteria. The five-headed QF (QF5) was the most common variant (54.11%), followed by the classical four-headed form (QF4) (40.74%). Rare morphologies with six to eight heads (QF6–QF8) were also documented. Among accessory heads, the vastus lateralis (VL) type was most prevalent (21.35%), while an independent tensor vastus intermedius (TVI) occurred in 13.54% of limbs. The QFT most frequently displayed a trilaminar structure (47.73%), with quadrilaminar architecture observed in 42.49%. The mean QFT length was 78.63 mm. Conclusions: This meta-analysis confirms that the QF often deviates from classical anatomical descriptions, frequently exhibiting supernumerary heads and multilayered tendon architecture. These findings highlight the importance of detailed preoperative imaging and personalized surgical planning to minimize complications and optimize graft selection in ACL reconstruction. Full article

Background and Objectives: This study aimed to evaluate the influence of the angle and position of the tibial tunnel in the coronal and sagittal planes on short-term postoperative clinical outcomes following arthroscopic anterior cruciate ligament reconstruction (ACLR). Materials and Methods: This retrospective study included 40 patients who underwent anatomical ACLR between 1 January 2023 and 31 December 2023 and had a follow-up period of at least 4 months. The angle of the tibial tunnel on the AP radiograph and both the angle and anteroposterior position on the lateral radiograph were measured. Clinical evaluations were conducted using the Visual Analogue Scale (VAS), the International Knee Documentation Committee (IKDC) score, and the Lysholm Knee Score, along with measurements of knee flexion and extension, to assess short-term outcomes at 1, 2, and 4 months postoperatively. Results: In patients whose tibial tunnels were positioned at 40–50° in the coronal plane, Lysholm scores were significantly higher at the 2nd and 4th months compared to other angles. In the sagittal plane, a tunnel angle between 30° and 40° was associated with significantly increased IKDC scores at both the 2nd and 4th months. Additionally, tunnels with an anterior–posterior ratio of 0.4–0.6 in the sagittal plane were associated with limitations in flexion and extension at the 4th month. There was no significant difference in VAS scores between the groups. Conclusions: Our findings suggest that optimizing the tibial tunnel angle in both the coronal and sagittal planes may play a crucial role in early postoperative knee function. Specifically, tibial tunnels placed between 40° and 50° in the coronal plane and 30° and 40° in the sagittal plane were associated with higher functional scores. However, tunnels positioned with an anterior–posterior ratio of 0.4 to 0.6 were linked to greater joint motion limitation. These findings indicate that angular and positional optimization of the tibial tunnel may have contributed to improved functional recovery following ACL reconstruction. Full article

Youth sport participation provides undeniable physical, emotional, and social benefits. However, the current landscape of pediatric athletics has shifted toward early sports specialization (ESS), year-round training, and heightened competitive pressures. This has led to an increased prevalence of overuse-related traumatic injuries in adolescent patients, as well as increased risk of worsening mental health due to burnout, depression, suicide, and general psychological distress. There are numerous innovations and solutions aimed at addressing the increased risk of injury associated with current sporting trends, such as neuromuscular training programs, delayed specialization, promotion of free play, and pediatric specific surgical techniques mindful of future growth, such as those seen for anterior cruciate ligament reconstruction (ACL-R). However, the social factors associated with an injury remain problematic and are not adequately addressed; these include social isolation, depression, anxiety, and academic decline. Sport psychology is a promising solution to address many risk factors associated with poor performance, address the challenges associated with injury, and increase return-to-play in adolescent sports medicine. Integrating sport psychology into pediatric sports medicine offers the ability to directly address the emotional and cognitive demands of injury and recovery. Emphasizing mental health support and redefining success in youth sports—prioritizing enjoyment, personal growth, and long-term health over scholarships and professional aspirations—are key steps in preserving the overall benefits of pediatric sport participation. Yet sport psychology remains often underutilized and has been slow to gain traction, particularly in youth sports. This editorial serves to highlight the current state of mental health advocacy in pediatric sports medicine and how sport psychology can help young athletes manage the mental stress of high-performance athletics and mitigate the detrimental effect of injury and delayed return to sport. Full article

Objective: The resistive knee orthosis, as a novel rehabilitation device, is designed to provide resistance to joint movement during continuous walking, thereby enhancing the postoperative recovery effect. This study aims to explore the impact of such orthoses on the joint coordination patterns of martial artists after anterior cruciate ligament (ACL) reconstruction. Methods: A total of 44 martial artists who underwent ACL reconstruction were recruited and divided into an experimental group (EG, n = 22, using resistive braces) and a control group (CG, n = 22, using conventional braces). Assessments were conducted preoperatively (T0) and at 15 days (T1), 30 days (T2), and 60 days (T3) postoperatively. The changes in joint coordination patterns during the gait cycle were analyzed, and the ACL force was estimated using a musculoskeletal model. Results: At T2 and T3, compared with the CG, the EG exhibited a significantly larger peak knee flexion angle (p < 0.05). At T3, the EG showed higher hip–ankle in-phase coordination (p < 0.05), increased proximal hip–knee coordination (p < 0.05), and decreased knee–ankle anti-phase coordination (p < 0.05). In addition, the ACL force in the EG was significantly lower. Conclusions: The resistive knee orthosis can effectively improve the joint coordination of martial artists after ACL reconstruction and reduce the ACL force. Full article

Objectives: Some following up patients have poor clinical outcomes when they experience anterior cruciate ligament reconstruction. The patient will undergo progression of knee joint osteoarthritis or several secondary knee procedures such as high tibial osteotomy, total knee arthroplasty, menisectomy, meniscus repair, or meniscus transplantation on their knees after anterior cruciate ligament reconstruction. This may be related to the remaining instability of the knee joint, changes in the knee joint biomechanics, and progression of osteoarthritis. This study aims to determine which secondary knee procedures are performed over time after anterior cruciate ligament reconstruction. Methods: The National Health Insurance Service-Health Screening database analyzed 146,122 patients who underwent ACL reconstruction surgery between 1 January 2002 and 31 December 2021. Secondary knee procedures were investigated by categorizing them into revisional reconstruction, high tibial osteotomy, total knee arthroplasty, menisectomy, meniscus repair, and meniscus transplantation, respectively. Multivariable Cox Proportional Hazard model analysis was used. The significant predictors for complications (p < 0.05) were as follows. Results: Among a total of 146,122 patients with anterior cruciate ligament reconstruction, 1073 (0.7%) patients underwent HTO, 908 (0.6%) patients underwent TKA, 15,218 (10.4%) patients underwent meniscectomy, 7169 (4.9%) patients underwent meniscus repair, and 938 (0.6%) patients underwent meniscus transplantation. The hazard ratio differed according to graft type, gender, and age group. Conclusions: Patients who undergo ACL reconstruction may experience poor clinical outcomes, such as progression of osteoarthritis and undergoing secondary knee procedures several years after ACL reconstruction. It is important for decision-making, ongoing monitoring, and follow-up care for patients undergoing ACL reconstruction. Full article

Background and Objectives: The anterior cruciate ligament (ACL) is crucial for knee stability, preventing anterior displacement of the tibia and rotation relative to the femur. Despite ACL reconstruction (ACLR), residual instability is common, affecting knee function. Anterolateral ligament reconstruction (ALLR) alongside ACLR improves outcomes, as the ALL plays a significant role in rotational stability. This study aims to assess the clinical and functional outcomes of the ACLR+ALLR combination using biomechanical testing in patients with at least ten months of follow-up. Materials and Methods: This cross-sectional comparative cohort study involves patients with ACLR. Inclusion criteria were adult patients who underwent ACLR within the last 3 years, with the same surgical technique performed by a single operator. Patients underwent anamnestic and clinical evaluation and completed Lysholm and KOOS questionnaires. Biomechanical tests included a Unilateral Drop Jump, a Countermovement Jump with knee rotation, and a five-repetition Sit-To-Stand. Force platforms, a camera, and surface electromyography were used to assess biomechanical stability and joint function. Results: This study included 18 subjects, 5 with ACLR and ALLR, and 13 with ACLR alone. The groups showed no significant differences in the KOOS and Lysholm scales and clinical outcomes. Muscle trophism reduction compared to the contralateral limb was noted in both groups. Biomechanical evaluations showed no difference in Quadriceps muscle activity during the landing phase of the Drop Jump. However, the ACL-ALL group exhibited fewer spikes and fewer knee joint angular excursions during ground impact stabilization. In the 5-STS task, a significant difference was observed in the vertical force peak. Differences in muscle activity during foot rotation and force components during the jumping phase were noted in the Countermovement Jump. Conclusions: ACLR combined with ALLR shows similar perceived joint function but improved biomechanical joint stability. Further studies with larger samples and longer follow-ups are needed for validation. Full article

Background and Objectives: Graft impingement against the intercondylar notch has been identified as a significant contributor to graft deterioration and suboptimal outcomes following anterior cruciate ligament (ACL) reconstruction. This study aimed to (1) identify the optimal combination of tunnel positions that minimizes impingement between the ACL graft and femoral intercondylar notch. Materials and Methods: Three-dimensional models of nine normal knees were reconstructed using computed tomography scans obtained at four knee flexion angles (0°, 45°, 90°, and 120°). Virtual ACL grafts with diameters of 7 mm and 9 mm were modeled as cylinders. Nine graft configurations were investigated by varying femoral and tibial footprint locations (anteromedial, central, and posterolateral) in all possible combinations. For each configuration, impingement volume was quantified by measuring the overlap between the intercondylar notch and the virtual graft using Boolean operators in 3D simulation software. The effects of graft diameter, footprint location, and knee flexion angle on impingement volume were analyzed. Results: Maximum impingement volumes were observed at 0° knee extension, with significant reductions at 45° flexion (p < 0.01) and negligible impingement at 90° and 120° flexion. The 9 mm diameter grafts demonstrated significantly greater impingement volumes than 7 mm grafts (p < 0.01). Impingement volumes increased progressively as footprint locations shifted from posterolateral to anteromedial positions in both femoral and tibial components. However, statistically significant differences in impingement volume across footprint locations were observed only for tibial positioning (p < 0.001), not for femoral positioning (p > 0.05). The femoral anteromedial-tibial anteromedial configuration exhibited the highest impingement volume (577.8 ± 171.3 mm³ for 9 mm grafts), while the femoral posterolateral-tibial posterolateral configuration showed the lowest (73.5 ± 85.6 mm³). Conclusions: Tunnel position, graft diameter, and knee flexion angle significantly influence impingement risk in ACL reconstruction. Tibial tunnel position appears more critical than femoral position in minimizing graft impingement. Posterolateral positioning of tunnels, particularly on the tibial side, may reduce impingement volume. Clinical Relevance: This study provides quantitative evidence to guide surgeons in optimizing tunnel placement and graft selection for anatomical single-bundle ACL reconstruction, potentially reducing the risk of graft deterioration and failure due to mechanical impingement. Full article

Background/Objectives: This retrospective study aimed to evaluate whether PRP infiltrations improve quadriceps muscle strength recovery following anterior cruciate ligament reconstruction (ACLR), while minimizing the recovery time required to resume daily activities and sports. Numerous studies have explored the use of platelet-rich plasma (PRP) in treating ACL injuries. PRP therapy has demonstrated high efficacy in accelerating ligament healing in animal models. However, clinical trials involving human participants have reported inconsistent results regarding the effects of PRP on ACL reconstruction outcomes. Methods: Between 2020 and 2024, a total of 68 subjects who underwent ACLR were included in the study. Participants were divided into two groups, namely a treatment group that followed a standard rehabilitation protocol and received PRP infiltrations, and a control group that followed the same protocol without PRP treatment. Muscle strength was assessed using the isometric max strength balance (IMSB) test and the concentric max strength balance (CMSB) test, both performed using the Kineo Intelligent Load device (Globus Kineo 7000, Italian Excellence, Rome, Italy). Results: The results of IMSB test showed a significant difference between treatment groups according to a two-way ANOVA test (F(1, 198) = 7.345; p = 0.0073). The PRP-treated group showed significantly higher quadriceps muscle strength at 6 months (34.9 ± 9.6 vs. 30.0 ± 8.2 kg). The CMSB test also showed a significant difference at 6 months (F(1, 198) = 5.976; p = 0.00154), with the PRP-treated group having significantly higher concentric muscle strength (35.5 ± 9.5 vs. 30.7 ± 8.5 kg). Conclusions: These findings suggest that post-ligamentoplasty PRP infiltrations may have beneficial effects on muscle strength recovery. However, further prospective studies with larger sample sizes are necessary to confirm these results. Full article

Background: The isolated rectus femoris tendon (RT) is a less commonly used autograft for anterior cruciate ligament (ACL) reconstruction. Graft selection is a critical part of ACL reconstruction, especially in revision surgery. Hypothesis: This study compares patient-reported outcome measurements (PROMs) between revision ACL reconstruction with an RT autograft and a hamstring tendon (HT) autograft. We hypothesized that the RT autograft will yield comparable functional results and high patient satisfaction. Study Design: This was a cohort study; the level of evidence is III. Methods: Fifty-five patients (RT n = 28; HT n = 27) who underwent revision ACL reconstruction were included in this study, with a mean follow-up time of 40.3 months (range, 16.4–64.8) for RT and 61.2 months (range, 34.6–86.3) for HT. Apart from the harvesting technique, the surgical technique was the same for both groups. Clinical and intraoperative data were collected for our postoperative registry. In addition, funcinal outcome was measured using the International Knee Documentation Committee score (IKDC), the Lysholm score, Tegner activity scale, and numeric rating scale (NRS). The type and frequency of postoperative complications were documented. Results: At the final follow-up, no significant differences were observed between the RT and HT groups in the IKDC (mean ± SD: 74.7 ± 10.9 vs. 74.9 ± 12.9), Lysholm score (90.9 ± 15.0 vs. 89.0 ± 14.6), or Tegner activity scale (median [IQR]: 5 [4–6] vs. 5 [4–6]). The mean femoral tunnel diameter was 9.0 mm (range, 7.5–10 mm) for the RT and 8.2 mm (range 7.0–9.5 mm) for the HT. The use of the RT reduced the need for a two-stage procedure by 50% compared to HT (n = 5 vs. n = 10), although this difference was not statistically significant (p = 0.11). Stability measured by the Lachman test improved significantly in both groups from the pre- to postoperative period. Retear of the ACL graft was observed in two patients in both groups (7.1% RT and 7.4% HT). Conclusions: The RT and HT autografts achieved similar outcomes in PROMs for revision ACL reconstruction. Good tendon quality with parallel fibers and adjustable thickness characterize the RT. A tendency for a reduced rate of two-stage surgery with RT was noticed. Clinical Relevance: The incidence of revision ACL reconstruction is rising. Surgeons should be aware of all the available graft options. The isolated RT expands the range of autografts available for ACL reconstruction. Full article

Objective: This study aimed to investigate the effects of neuromuscular electrical stimulation (NMES) on lower limb muscle synergies during the single-leg hop test in martial artists after anterior cruciate ligament (ACL) reconstruction. Methods: Twenty-four martial artists who underwent ACL reconstruction were recruited and performed a single-leg hop test under two conditions: with NMES (ES) and without NMES (CON). The ES condition involved using Compex SP 8.0 to deliver biphasic symmetrical wave stimulation. Jump performance metrics and electromyographic (EMG) signals were recorded. Muscle synergies of the lower limbs were extracted using non-negative matrix factorization (NMF) to analyze patterns of muscle coordination. Results: Compared with the CON condition, the ES condition significantly reduced the jump time (0.13 ± 0.05 vs. 0.18 ± 0.09; F = 5.660; p = 0.022) and significantly increased the contact time (0.53 ± 0.12 vs. 0.43 ± 0.21; F = 4.013; p = 0.049). Muscle synergy analysis revealed three distinct synergy patterns under both conditions. For synergy pattern 1, compared with the CON condition, the muscle weightings of the rectus femoris and tibialis anterior muscles were significantly increased under the ES condition (p < 0.001). For synergy pattern 2, compared with the CON condition, the muscle weighting of the lateral gastrocnemius muscle was significantly increased under the ES condition (p < 0.001). Additionally, the activation timing of synergy pattern 2 was significantly reduced under the ES condition (p = 0.001). Conclusion: Neuromuscular electrical stimulation enhances jump performance and alters muscle synergy patterns in martial artists after ACL reconstruction. The findings suggest that NMES can promote better lower limb muscle coordination during jumping tasks, potentially aiding in postoperative rehabilitation and performance optimization. Full article

Background/Objectives: The correct angular placement of the tibial tunnel is crucial to ensure graft tension, maintain knee stability, and ensure optimal clinical outcomes after anterior cruciate ligament (ACL) reconstruction. While 3D imaging methods such as MRI and CT are the gold standard for evaluating tunnel positioning, their routine use is limited by cost, availability, and time constraints. In clinical practice, 2D radiographs are more accessible but lack established reliability in accurately estimating tunnel angles. The aim of this study was to convert 2D radiographic angular measurements used in the evaluation of patients undergoing anterior cruciate ligament reconstruction into 3D values with a simple method and to compare these measurements with three-dimensional angles calculated using conventional MRI and CT. Methods: This retrospective study included 38 patients who underwent anatomic anterior cruciate ligament reconstruction. Postoperative radiographs and MR images were analyzed to determine the tibial tunnel angles. The angles calculated from 2D radiographs were statistically analyzed for their correlation with the actual 3D angles measured by MRI. Results: The analysis showed a strong correlation between tibial tunnel angles from radiographs and MRI, with minimal, non-significant differences. This suggests that radiographs can provide a reliable estimate of tibial tunnel angles. Conclusions: These findings suggest that radiographs can predict tibial tunnel angles in ACL reconstruction as accurately as MRI. This method can guide the correct tunnel angle and facilitate postoperative evaluation. Further studies are needed to confirm these results across various populations and techniques. Full article

Background: Anterior cruciate ligament (ACL) injuries are common among athletes and significantly impact their knee stability and performance. Surgical reconstruction is the standard treatment. The modified transtibial technique has emerged as a promising surgical approach for optimal graft positioning and complication reduction. Methods: A retrospective study of athletes who underwent primary ACL reconstruction with the modified transtibial technique was conducted. Clinical outcomes were evaluated using the Lysholm and International Knee Documentation Committee (IKDC) subjective scores and objective knee stability assessments. Return-to-sport rates and associated factors were analyzed. Results: Forty-four athletes were included (thirty-seven males, seven females; mean age 21.2 ± 5.0 years). At mean follow-up of 27.0 ± 12.2 months, significant improvements in the Lysholm and IKDC subjective scores were observed. Overall, 88.2% of athletes returned to sports, and 65.9% achieved their pre-injury levels. Return to pre-injury level was defined as regaining the same type, intensity, and frequency of sport participation as before the injury occurred. Professional athletes showed significantly higher return-to-pre-injury-sport rates (79.3%) than recreational athletes (40.0%, p = 0.0091). Concomitant meniscus injuries negatively impacted return-to-sport rates (92.9% versus 66.7%, p = 0.0397). The overall failure rate was 4.6% (2/44; 95% confidence level [CI]: 0.6–15.5%) with two cases of graft insufficiency or re-rupture. Conclusions: ACL reconstruction with the modified transtibial technique provides favorable clinical outcomes, high return-to-sport rates, and low failure rates, particularly among professional athletes. Meniscus preservation is crucial for optimizing post-operative recovery. Future research should focus on long-term outcomes and comparative studies with other ACL reconstruction techniques. Full article

Machine learning-based tools are becoming increasingly popular in clinical practice. They offer new possibilities but are also limited in their reliability and accuracy. The present systematic review updates and discusses the existing literature regarding machine learning algorithm-based identification of cruciate ligament injury on radiographic images. PubMed was searched for articles containing machine learning algorithms related to cruciate ligament injury recognition. No additional filters or time constraints were used. All eligible studies were accessed by hand. From the 115 articles initially retrieved, 29 articles were finally included. Only one study included the posterior cruciate ligament (PCL). Deep learning algorithms in the form of convolutional neural networks (CNNs) were most frequently used. Many studies presented CNNs that identified binary decision classes of regular and torn anterior cruciate ligaments (ACLs) with a best sensitivity of 0.98, a specificity of 0.99, and an AUC ROC of 1.0. Other studies expanded the decision classes to partially torn ACLs or reconstructed ACLs, usually at the cost of sensitivity and specificity. Deep learning algorithms are excellent for identifying ACL injuries, tears, or postoperative status after reconstruction on MRI images. They are much faster but only sometimes better than the human reviewer. While the technology seems ready, barriers to ethical and legal issues and clinicians’ refusals must be overcome to some extent. It can be firmly assumed that artificial intelligence will have a future contribution in the diagnosis of cruciate ligament injuries. Full article