{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:12:30Z","timestamp":1781194350545,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":57,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of the present study was to compare clinical and radiological outcomes between the all\u2010inside single bundle (SB) and a modified double\u2010bundle (DB) anterior cruciate ligament reconstructions (ACLR) at over 5\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is an observational, retrospective comparative, two\u2010centre study. Clinical outcomes were evaluated using Lysholm and International Knee Documentation Committee (IKDC) scores, and anterior tibial translation (ATT) was assessed using the KT\u20101000 arthrometer. Knee x\u2010ray images were recorded, classified according to the KL grading and compared with radiographs of the same patient before surgery. Inclusion criteria were patients undergoing ACLR, age between 18 and 45 years and negative knee history of major traumatic events after surgery. Exclusion criteria were congenital laxity, combined multiple knee ligament injuries, patients undergoing ACL revision surgery, history of infection, lower limb coronal axial deviation &gt;5\u00b0, patients undergoing lateral extra\u2010articular tenodesis or anterolateral ligament reconstruction, patients with chondral damage Outerbridge grade &gt;2, patients with meniscal tears undergoing subtotal meniscectomy or meniscal repair and patients with knee OA Kellgren\u2013Lawrance (KL) grade &gt;3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and fifty\u2010two patients were included in the study. Patients were divided into two groups according to surgical technique: Group A\u2014ACLR with all\u2010inside technique, and Group B\u2014ACLR with modified DB technique. There were no statistical differences between groups for age, side, gender or time since surgery.<\/jats:p><jats:p>There were no statistically significant differences between groups for Lysholm scores (<jats:italic>p<\/jats:italic>\u2009=\u20090.43), IKDC (<jats:italic>p<\/jats:italic>\u2009=\u20090.88), ATT (<jats:italic>p<\/jats:italic>\u2009=\u20090.105) and KL grade (<jats:italic>p<\/jats:italic>\u2009=\u20090.93 before surgery, 0.99 at the fu). KL grade increased significantly since pre\u2010op.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data show significant improvements in all clinical outcome measures, along with excellent KT\u20101000 arthrometer values and low clinical failure rates for both the SB all\u2010inside and modified DB techniques at a mean follow\u2010up of over 6 years. There were no significant differences in arthritic progression according to KL grade between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level III.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jeo2.70100","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T18:57:06Z","timestamp":1741633026000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["All\u2010inside single\u2010bundle and modified double\u2010bundle anterior cruciate ligament reconstruction techniques guarantee stability and similar clinical results at over 5 year follow\u2010up"],"prefix":"10.1002","volume":"12","author":[{"given":"Lorenzo","family":"Moretti","sequence":"first","affiliation":[{"name":"Department of Translational Biomedicine and Neuroscience (DiBraiN), Orthopaedic and Trauma Unit, AOUC Policlinico di Bari University of Bari \u201cAldo Moro\u201d  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Garofalo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Ente Ecclesiastico Ospedale \u201cF. Miulli\u201d Acquaviva delle Fonti Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9212-1253","authenticated-orcid":false,"given":"Giuseppe Danilo","family":"Cassano","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Ente Ecclesiastico Ospedale \u201cF. Miulli\u201d Acquaviva delle Fonti Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Calbi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Ente Ecclesiastico Ospedale \u201cF. Miulli\u201d Acquaviva delle Fonti Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Fiore","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Ente Ecclesiastico Ospedale \u201cF. Miulli\u201d Acquaviva delle Fonti Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Solarino","sequence":"additional","affiliation":[{"name":"Department of Translational Biomedicine and Neuroscience (DiBraiN), Orthopaedic and Trauma Unit, AOUC Policlinico di Bari University of Bari \u201cAldo Moro\u201d  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1598176"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513508376"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1381960"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-010-1371-2"},{"issue":"9","key":"e_1_2_11_6_1","first-page":"14604","article-title":"Comparison of single\u2010bundle versus double\u2010bundle anterior cruciate ligament 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