Second anterior cruciate ligament (ACL) injury after ACL reconstruction (ACL-R) is a dreaded potential complication to both patients and healthcare professionals.1 Research conducted throughout the 2010s has helped identify factors influencing second ACL injury risk after ACL-R and the multifactorial causes of second ACL injury are now well established, with patient anatomy, surgical factors and components of the rehabilitation process each playing essential roles.2 Despite the wealth of existing knowledge, additional contributors to second ACL injury may be overlooked due to the focus on complex interactions between a subset of risk factors. To avoid missing the forest for the trees, we cannot afford to overlook more straightforward reasons that lead to second ACL injuries. Generalised joint hypermobility (GJH) is one such contributor to the increased risk of reinjury after primary ACL injury. This editorial presents the rationale for an assessment of GJH in all patients with an ACL injury. A clinical phenotype with a heterogeneous genetic background, GJH is characterised by increased mobility in multiple synovial joints.3 The assessment of GJH is conducted with the Beighton score,4 determined by the positive results of joint mobility tests (figure 1). The tests are evaluated on a nine-point scale, and a cut-off value (typically four or five) indicates GJH. Cut-off scores for GJH may vary by age, pubertal status and patient sex. However, consensus is currently lacking regarding the Beighton score cut-off for GJH, …

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对所有 ACL 损伤患者进行全身关节过度活动评估的日子已经到来

ACL 重建 (ACL-R) 后第二前交叉韧带 (ACL) 损伤对于患者和医疗保健专业人员来说都是一种可怕的潜在并发症。1 整个 2010 年代进行的研究帮助确定了影响 ACL-R 后第二次 ACL 损伤风险的因素以及多因素第二次 ACL 损伤的原因现已明确，患者解剖结构、手术因素和康复过程的各个组成部分都发挥着重要作用。2 尽管现有知识丰富，但由于关注复杂的复杂因素，导致第二次 ACL 损伤的其他因素可能会被忽视。风险因素子集之间的相互作用。为了避免只见树木、不见森林，我们不能忽视导致第二次 ACL 损伤的更直接的原因。全身性关节过度活动 (GJH) 是导致原发性 ACL 损伤后再次受伤风险增加的因素之一。这篇社论阐述了对所有 ACL 损伤患者进行 GJH 评估的基本原理。 GJH 是一种具有异质遗传背景的临床表型，其特点是多个滑膜关节活动度增加。3 GJH 的评估采用 Beighton 评分进行，4 由关节活动度测试的阳性结果确定（图 1）。测试按九分制进行评估，截止值（通常为四或五）表示 GJH。 GJH 的截止分数可能因年龄、青春期状态和患者性别而异。然而，目前对于 GJH 的 Beighton 分数截止点缺乏共识，……