🎯 Título: La hiperlaxitud articular y el riesgo de una segunda lesión de LCA
📌 En breve: Cada prueba positiva de hiperlaxitud articular (escala de Beighton) se asoció con un aumento moderado del riesgo de sufrir una segunda lesión de LCA tras volver al deporte.
🔬 Puntos clave:
### El estudio
Estudio de registro con 935 pacientes (edad promedio 23,7 años, 51,4% mujeres) que se sometieron a reconstrucción primaria de LCA, con seguimiento promedio de 54,4 meses tras el retorno al deporte.
### Resultados
La incidencia acumulada de una segunda lesión de LCA fue del 13,1% (7,4% por ruptura del injerto, 5,7% por lesión del LCA contralateral). Cada prueba positiva adicional de hiperlaxitud en la escala de Beighton se asoció con un aumento del 10% en el riesgo de segunda lesión de LCA en general (p = 0,044, un resultado en el límite de la significancia estadística) y del 15% específicamente para ruptura del injerto (p = 0,031). No se encontró asociación significativa con la lesión del LCA contralateral.
### Qué significa
A mayor grado de hiperlaxitud articular (no solo si está presente o no), mayor sería el riesgo de volver a lesionar el injerto reconstruido.
🎯 Aplicación clínica para LATAM: Cirujanos y fisioterapeutas de la región podrían usar el número de pruebas positivas de Beighton (no solo un umbral binario) como parte de la evaluación de riesgo antes de autorizar el retorno al deporte tras reconstrucción de LCA.
⚠ Limitaciones: El intervalo de confianza para el riesgo general de segunda lesión fue estrecho (rozando 1,0 en su límite inferior), por lo que este hallazgo específico debe interpretarse con cautela pese a ser estadísticamente significativo.
Background
Generalized joint hypermobility (GJH) has been associated with increased risk of second anterior cruciate ligament (ACL) injury. The clinical diagnosis of GJH relies on a binary threshold of positive joint hypermobility tests, based on age and patient sex, which may overlook the degree of hypermobility.
Objectives
To analyze the association between the number of positive joint hypermobility tests on the Beighton Score and the hazard of second anterior cruciate ligament (ACL) injury in patients who return to sport (RTS) after primary ACL reconstruction, which included secondary, stratified analyses of graft rupture and contralateral ACL injury.
Design
Registry study.
Methods
Data were extracted in January 2026 from an ACL-rehabilitation-specific registry, Project ACL. Included patients were 15-50 years who underwent primary ACL reconstruction with hamstring tendon or bone-patellar tendon-bone autograft, had a documented Beighton Score, participated in knee-strenuous sports before injury, had RTS, reported second ACL injury or had ≥ 1 year follow-up without second ACL injury after RTS. Multivariable Cox proportional hazard regression was used to estimate the cause-specific hazard ratio (HR) of second ACL injury (measured from RTS) based on the Beighton Score, adjusted for age, return to pre-injury physical activity level or higher, graft choice, knee hyperextension (≥ 10° knee extension), and patient sex, accounting for competing risks.
Results
The analysis included 935 patients (mean age 23.7 ± 7.8 years, 51.4% female), with median Beighton Score of 2 (interquartile range: 4). The median follow-up time was 54.4 months. The cumulative incidence of second ACL injury after RTS was 13.1%. Specifically, the cumulative incidence for graft rupture was 7.4% and 5.7% for contralateral ACL injury. For the primary outcome, each additional positive joint hypermobility test on the Beighton Score was associated with a significantly increased hazard of second ACL injury (adjusted HR: 1.10 (95% CI 1.003-1.22, p = 0.044). For the secondary outcomes, each additional test was associated with an increased hazard of graft rupture (adjusted HR: 1.15, 95% CI 1.01-1.30, p = 0.031), whereas no statistically significant association was observed for contralateral ACL injury.
Conclusions
The HR of second ACL injury (graft rupture or contralateral ACL injury) after RTS in patients who had undergone primary ACL reconstruction increased by 10%, and by 15% for isolated graft rupture, for each positive joint hypermobility test on the Beighton Score, while no association was observed for contralateral ACL injury.
Cómo citar:
Lindskog J, Zsidai B, Sundberg A, Högberg J, Hamrin Senorski R, Liaghat B, Samuelsson K, Thomeé R, Piussi R, Hamrin Senorski E. (2026).
Increased Hazard Ratio of a Second ACL Injury After Return to Sport for Each Positive Hypermobility Test on the Beighton Score: A Registry Study.. Sports medicine - open.
DOI: 10.1186/s40798-026-01054-5 ↗ PMID: 42334734 ↗ Acceso al paper: Ver completo ↗
