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A review on range of tibial rotation452degree of knee flexion, no more increase in range of tibial rotation is seen, plus it would be of less clinical importance given the fact that the stance phase in most activities will not include a knee flexed to more than 90 degrees of flexion. ConclusionThere is no a gold standard for measuring tibial rotation in current literature. Compared to the pre-operative state, an ACL reconstruction seems to achieve a reduction of 17-32% of range of tibial rotation, measured with CAS. Whether it returns to pre-injury levels remains unclear.Based on the reviewed literature the use of CAS in studying ACL deficient and ACL reconstructed subjects shows reproducible results. However there are still many varying protocols being used. This review shows that, when using CAS, a maximum force of 5 Nm and flexion angles of 0,30 and 60 degrees are sufficient to detect relevant differences between the ACL deficient and ACL reconstructed state. Normal values for the range of tibial rotation in ACL deficient and ACL reconstructed patients cannot be provided based on the current available literature due to lack of a uniform measuring techniques and protocols. The authors advocate uniformity in measuring tibial rotation as described above. When future research is focussed around a uniform research protocol a meta-analysis might become within reach. AcknowledgementsThe authors thank Truus van Ittersum for her contribution in retrieving and organizing the search results.Mark Zee.indd 45 03-01-2024 08:56