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Tennis specific limitations in players with an ACL deficient knee
  1. J Maquirriain1,
  2. P J Megey2
  1. 1National High Performance Training Centre (CeNARD), Argentine Tennis Association, Buenos Aires, Argentina
  2. 2San Isidro Hospital, Buenos Aires
  1. Correspondence to:
 Dr Javier Maquirriain
 National High Performance Training Centre (CeNARD), Argentine Tennis Association, Pilar, Buenos Aires, Argentina; jmaquirriain{at}


Background: Complete rupture of the anterior cruciate ligament (ACL) causes significant alteration of knee joint kinematics. Untreated patients often develop joint instability, chronic articular degeneration, and knee dysfunction. Demands on the ACL produced by playing tennis have not been investigated.

Objective: To identify subjective sport-specific limitations in tennis players with isolated unilateral ACL deficiency.

Study design: Prospective case–control study.

Methods: 16 players (mean (SD) age, 39.9 (2.3) years; 14 men) with a chronic unilateral ACL deficient knee and 16 healthy controls (38.25 (8.47) years; 14 men) were recruited. ACL deficiency was confirmed by clinical and magnetic resonance imaging. A Lysholm score was obtained in all patients, together with subjective evaluation of their current tennis performance compared with pre-injury levels, applying a 0–100% visual scale. Both groups completed a questionnaire on tennis specific abilities.

Results: Lysholm scores were: 85.6 (10.3) points in the study group and 100 (0) points in the control group (p<0.001, t test for independent samples). Injured players evaluated their current tennis performance as 66.8 (15.2)% compared with 100% pre-injury level (p<0.005, t test for dependent samples). Abilities affected in the ACL deficient group were landing after a smash stroke (p<0.001); stopping abruptly and changing (p<0.001); playing a three set singles match (p<0.05); and playing on a hard court surface (p<0.001, Kolmogorov-Smirnov test).

Conclusions: There are specific limitations associated with complete isolated ACL rupture, including subjective tennis performance impairment, limitations landing after a smash, stopping and changing step direction, difficulties playing a three set singles match, and playing on hard court surfaces.

  • ACL, anterior cruciate ligament
  • knee
  • ligament
  • anterior cruciate ligament
  • tennis

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  • Competing interests: none declared