{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:02:56Z","timestamp":1789844576658,"version":"4.0.1"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To report long\u2010term outcome of anterior cruciate ligament reconstruction (ACLR) using the medial third of the patellar tendon in terms of knee function evaluated with clinical assessments, patient\u2010reported outcomes (PROs) and radiological examinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty patients were retrospectively evaluated 16.8\u2009\u00b1\u20090.3 (range 16.2\u201317.4) years after the index operation for anterior knee pain, side\u2010to\u2010side difference in anterior tibial translation (ATT), Lysholm score, Tegner score, subjective International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS) and radiographic evidence of osteoarthritis (Kellgren\u2013Lawrence osteoarthritis [OA] grading).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Incidence of donor\u2010site knee pain was 7.5% and the severity of the pain ranged 0.5\u20135.5 on visual analogue scale. Incidence of kneeling pain was 17.5% and the severity of pain ranged 3\u20137. There were no evidence for side\u2010to\u2010side differences in ATT (operated: 2.0\u2009\u00b1\u20090.7 vs. intact: 2.0\u2009\u00b1\u20090.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.867). Lysholm had very large correlation with KOOS\n                      <jats:sub>QoL<\/jats:sub>\n                      (0.77 [0.58; 0.90],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). IKDC had very large correlations with KOOS\n                      <jats:sub>sports<\/jats:sub>\n                      and KOOS\n                      <jats:sub>QoL<\/jats:sub>\n                      (0.75 [0.56; 0.87],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 and 0.70 [0.48; 0.85],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). KOOS\n                      <jats:sub>sports<\/jats:sub>\n                      and KOOS\n                      <jats:sub>ADL<\/jats:sub>\n                      had the strongest correlation (0.79 [0.60; 0.91],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Approximately 55% of the sample had IKDC Z\u2010score higher than age\u2010matched population average and approximately 75%\u201380% of the sample was above the established PASS thresholds. The operated side exhibited more pronounced progression of knee osteoarthritis (higher K\u2010L grade) (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200912.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002); however only five knees in total (four operated, one intact) had Grade 2 radiographic OA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Long\u2010term clinical outcomes following ACLR with the medial third of the patellar tendon demonstrate a low incidence of anterior knee pain, excellent anterior\u2010posterior stability and low rate of mild radiographic osteoarthritis. The majority of patients had achieved acceptable knee function and symptom resolution. These findings suggest that the medial third of the patellar tendon autograft is a reliable option for achieving sustained knee function and high patient satisfaction in the long term.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70483","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T17:24:46Z","timestamp":1761672286000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long\u2010term results of anterior cruciate ligament reconstruction using the medial third of the patellar tendon"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5757-4772","authenticated-orcid":false,"given":"Jim","family":"Georgoulis","sequence":"first","affiliation":[{"name":"1st 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