{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:09:34Z","timestamp":1780315774670,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To quantitatively determine the attachment location for lateral extra\u2010articular procedures (LEAP) relative to the lateral physes using magnetic resonance imaging (MRI) to guide implant placement and physeal avoidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included a consecutive series of skeletally immature patients who underwent a knee MRI between 2000 and 2023. The LEAP attachment locations relative to the femoral and tibial physes were determined using MRI in skeletally immature knees without evidence of knee injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five hundred ninety\u2010nine individual knee MRI studies met the inclusion criteria (285 males, 314 females). Chronological and bone age for both males (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009.92,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0001) and females (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009.89,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0001) were strongly correlated; mean chronologic age was 14.4 years (SD 2.8) for males and 14.1 years (SD 2.6) for females. Mean distance from femoral LEAP attachment to the physis was 8.7\u2009mm (SD .1) in males and 7.1\u2009mm (SD .1) in females, increased with increasing age for males (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0001). Mean distance from the tibial ALL attachment to the physis was 11.0\u2009mm (SD .1) in males and 9.4\u2009mm (SD .1) in females, increased with increasing age (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0001). Mean lateral\u2010femoral physeal obliquity was 28.5\u00b0 (SD .4) in males and 30.0\u00b0 (SD .4) in females (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0001). Mean tibial physeal obliquity 29.2\u00b0 (SD .4) in males and 33.1\u00b0 (SD .4) in females (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0004). The proximity of femoral surface attachment was closer to the physis than the tibial attachment across all patients, 7.8\u2009mm vs 10.1\u2009mm (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The lateral femoral and tibial physes are close to surface attachment points for LEAP performed in conjunction with anterior cruciate ligament reconstruction in skeletally immature patients. The femoral LEAP surface attachment was significantly closer to the physis compared to the tibial attachment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>LEAP are performed more frequently with anterior cruciate ligament reconstruction in skeletally immature patients and avoidance of physeal injury is important.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70073","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:15:53Z","timestamp":1773000953000},"page":"914-919","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surface Attachment Points for Lateral Extra\u2010articular Procedures Are in Close Proximity to the Femoral and Tibial Physes in Skeletally Immature Patients"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4010-0500","authenticated-orcid":false,"given":"Mitchell T.","family":"Gray","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Rehabilitation University of Vermont  Burlington Vermont U.S.A."},{"name":"Larner College of Medicine University of Vermont  Burlington Vermont U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Danaher","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Rehabilitation University of Vermont  Burlington Vermont U.S.A."},{"name":"Larner College of Medicine University of Vermont  Burlington Vermont U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew G.","family":"Geeslin","sequence":"additional","affiliation":[{"name":"Larner College of Medicine University of Vermont  Burlington Vermont U.S.A."},{"name":"Department of Radiology University of Vermont  Burlington Vermont U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert","family":"Moatshe","sequence":"additional","affiliation":[{"name":"Oslo Sports Trauma Research Center  Oslo Norway"},{"name":"Orthopaedic Department Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9410-9936","authenticated-orcid":false,"given":"Andrew G.","family":"Geeslin","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Rehabilitation University of Vermont  Burlington Vermont U.S.A."},{"name":"Larner College of Medicine University of Vermont  Burlington Vermont U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07005-3"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5072-6"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-195840040-00006"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517707961"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515578253"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2014.09.010"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"232596712312118","DOI":"10.1177\/23259671231211885","article-title":"Association of lateral extra\u2010articular tenodesis with improved graft maturity on mri 2 years after acl reconstruction with quadriceps tendon autograft in skeletally immature 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