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Single-leg squat knee biomechanics at 4 months post-operation predicts 6- and 12-month outcomes after anterior cruciate ligament reconstruction: a cohort study.

Created on 18 Aug 2026

Authors

Tian-Yi Zang, Ransi S S Subasinghe Arachchige, Roy Tsz-Hei Cheung, Mingde Cao, Dennis Cham-Kit Wong, Rex Wang-Fung Mak, Jonathan Patrick Ng, Daniel T P Fong, Michael Tim-Yun Ong, Patrick Shu-Hang Yung

Published in

Research in sports medicine (Print). Pages 1-14. Aug 18, 2026. Epub Aug 18, 2026.

Abstract

Persistent functional deficits frequently complicate recovery following anterior cruciate ligament reconstruction (ACLR). This prospective cohort study investigated whether sagittal-plane knee biomechanics during a single-leg squat at 4 months post-ACLR predict functional outcomes at 6 and 12 months. Fifty-three participants underwent 3D biomechanical analysis at 4 months to measure peak knee flexion angle and moment (KFM). Clinical outcomes, including muscle strength, hop performance, and patient-reported measures, were assessed at follow-up. Regression analysis revealed that 4-month peak KFM was a consistent independent predictor of future function. Higher KFM significantly predicted greater 6-month International Knee Documentation Committee (IKDC) scores and knee extension strength, with predictive value for strength persisting at 12 months. Conversely, among the sagittal-plane variables examined, peak KFM was a stronger predictor of 6- and 12-month outcomes than peak KFA, suggesting that internal knee loading strategy during the single-leg squat (SLS) may carry greater prognostic value than squat depth. Further research is needed to determine whether biomechanical variables from other planes contribute additional predictive information.

PMID:
42611046
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

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