ArticleOrthopaedic journal of sports medicine2021
Influence of Graft Bending Angle on Femoral Tunnel Widening After Double-Bundle ACL Reconstruction: Comparison of Transportal and Outside-In Techniques.
Article in Orthopaedic journal of sports medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06357091 (ACL Reconstruction With Human Allograft Cortical Bone Screw), which is not on this map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
ACL Reconstruction With Human Allograft Cortical Bone Screw (Shark Screw®) or Biocomposite-interference Screws - a Prospective, Randomized, Controlled Trial.
Who cites it
9 citing papers in PubMed.
- No single best technique: trade-offs in femoral interference screw fixation for bone-patellar tendon-bone anterior cruciate ligament reconstruction.EFORT open reviews · 2026Review
- Effects of Graft Bending Angle on the Tensile Behavior of Bone Tunnel-Graft Constructs for Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Graft.Bioengineering (Basel, Switzerland) · 2026Article
- Review
- Modification of Outside-In Technique In Preparing Femoral Tunnel During Anterior Cruciate Ligament Reconstruction-"PL-Portal Outside-In Technique".Arthroscopy techniques · 2024Article
- Graft impingement increases anterior cruciate ligament graft signal more than acute graft bending angle: magnetic resonance imaging-based study in outside-in anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Influence of knee flexion angle on graft bending angle during anterior cruciate ligament reconstruction using the transportal technique.Scientific reports · 2023Article
- Beneficial Effect of Curved Dilator System for Femoral Tunnel Creation in Preventing Femoral Tunnel Widening after Anterior Cruciate Ligament Reconstruction.Medicina (Kaunas, Lithuania) · 2023Article
- Eccentrically widened bone tunnels after all-inside anterior cruciate ligament reconstruction: a computed tomography and three-dimensional model-based analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Femoral Tunnel Geometry and Graft Inclination Angles in Anterior Cruciate Ligament Reconstruction Using a Flexible Reamer System.Medicina (Kaunas, Lithuania) · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies have suggested that increased mechanical stress due to acute graft bending angle (GBA) is associated with tunnel widening and graft failure after anterior cruciate ligament (ACL) reconstruction. Few studies have compared the GBA between the outside-in (OI) and the transportal (TP) techniques. PURPOSE: To evaluate the influence of GBA on clinical outcomes and tunnel widening after ACL reconstruction with OI versus TP technique. STUDY
designCohort study; Level of evidence, 3.
methodsIncluded in the study were 56 patients who underwent double-bundle ACL reconstruction (n = 28 in the OI group and n = 28 in the TP group). Clinical outcomes (Lysholm, International Knee Documentation Committee, Tegner score, and knee laxity) 1 year postoperatively were evaluated. Computed tomography scans at 5 days and 1 year postoperatively were used for imaging measurements, and the femoral tunnel was divided into the proximal third, middle, and aperture sections. The GBA and cross-sectional area (CSA) were measured using image analysis software and were compared between groups. A correlation analysis was performed to determine if the GBA affected clinical outcomes or tunnel widening.
resultsNo significant difference was observed in clinical outcomes between the groups. The GBA of both the anteromedial (AM) and posterolateral bundles were more acute in the OI group compared with the TP group (
conclusionRegardless of technique, the GBA did not have a significant influence on tunnel widening or clinical outcomes. Considering a wider AM tunnel aperture, a more proximal and posterior AM tunnel position might be appropriate with the OI technique.
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