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Chapter 9176In Chapter 3 we showed that, in contrast with the result of passive testing as reported in Chapter 2, within three months of ACL injury the dynamic range of tibial rotation is not increased. In fact, the range of tibial rotation that we measured was even smaller in ACL-injured knees compared to contralateral intact knees, albeit not significantly. When performing the same tests again one year after ACL reconstruction, we found that the range of tibial rotation approached that of the contralateral intact knee, but was still smaller in ACL-reconstructed knees than in intact knees. This study supports the theory that dynamic range of tibial rotation is essentially different from passive range of tibial rotation.In Chapter 4 we showed that the dynamic range of tibial rotation has a strong positive correlation with self-reported knee function and psychological readiness to return to sports in high-demand functional tasks. We observed that the more closely knee kinematics resemble those of a normal knee, the better the subjective knee function scores and the better the reported psychological readiness to return to sports. Another important finding that we demonstrated in this chapter is that dynamic anterior tibial translation has a low correlation with psychological readiness to return to sports. This supports the hypothesis that not control of translation but control of rotation could be the most important factor influencing actual or subjective function after ACL rupture and reconstruction.In Chapter 5 we found a moderate-to-strong correlation between amount of posterior tibial slope and dynamic range of tibial rotation. In a dynamic setting, we found only a low correlation between anterior tibial translation and posterior tibial slope. This implies that in a dynamic setting, muscular activity can compensate for the anterior translation of the tibia but effectively falls short in compensating for its rotational movement.. We concluded that bone morphology can contribute to altered knee kinematics after ACL reconstruction. Hence this is another factor that we need to take into account in the process of individualising ACL reconstruction. The second part of this thesis focuses on this individualising process and aimed to develop a patient-specific guide to ensure a femoral tunnel Mark Zee.indd 176 03-01-2024 08:56