ABSTRACT Purpose This study aimed to identify preoperative and postoperative risk factors associated with the development of arthrogenic muscle inhibition (AMI) in patients undergoing anterior cruciate ligament reconstruction (ACLR). The hypothesis was that distinct risk factors contribute to the occurrence of preoperative and postoperative AMI. Methods A retrospective cohort study included 169 patients who underwent ACLR using a hamstring autograft combined with anterolateral ligament reconstruction between November 2022 and December 2023. AMI was clinically assessed preoperatively (t0), and at 45 days (D45) and 90 days (D90) postoperatively. Demographic, clinical and perioperative variables were collected. A combination of descriptive statistics and inferential tests was used, followed by univariate and stepwise multivariable logistic regression to identify independent predictors of AMI. Results AMI was observed in 33.7% of patients. Its prevalence was 15% at t0, 22% at D45 and 18% at D90. Preoperatively, patients with AMI demonstrated reduced knee flexion range ( p < 0.001) and a shorter delay between injury and consultation ( p < 0.001); AMI was significantly associated with joint effusion (odds ratio OR = 8.97; p < 0.001) and bucket‐handle meniscal tears (OR = 5.24; p = 0.016). Postoperatively, significant predictors included female sex (OR = 2.98; p = 0.009), lateral femorotibial cartilage lesions (OR = 8.63; p = 0.004) and preoperative AMI (OR = 3.56; p = 0.008). Pain intensity was not significantly associated with AMI at any assessment point (not significant n.s.). Conclusion AMI affects approximately one‐third of patients undergoing ACLR and may persist for at least three months postoperatively. Distinct preoperative and postoperative risk factors were identified, with preoperative AMI strongly predicting its persistence. Joint effusion and specific meniscal lesions appear to act as preoperative triggers, whereas cartilage damage and sex may influence postoperative evolution. Early identification and management of modifiable risk factors, particularly before surgery, may help optimize rehabilitation and limit the persistence of AMI after ACLR. Level of Evidence Level III.
Morel et al. (Tue,) studied this question.