{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:02:50Z","timestamp":1789844570441,"version":"4.0.1"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":29,"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>The aim of the present study was to compare the tibial rotation between patients who have undergone unilateral versus bilateral ACL reconstruction (ACLR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients who underwent primary bilateral ACLR at our institution from the years 2010 to 2022 were retrospectively identified (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200949). Exclusion criteria were: simultaneous injury (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), not available magnetic resonance imaging (MRI) or surgical report (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913), or were older than 50 at the time of first ACL injury (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911). Twenty\u2010three patients were eligible for matching. A retrospective database analysis of consecutive unilateral primary ACL from 2019 to 2021 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009572) was performed. Patients with previous knee surgery, lateral collateral ligament and\/or posterior cruciate ligament and\/or posterolateral corner injury and fractures around the knee were excluded from the study. Those who had undergone unilateral ACLR with\u2009&lt;\u20093\u2010year follow\u2010up were further excluded. Twenty\u2010three patients of case were matched with 96 unilateral ACL control by age, gender, body mass index and Tegner activity level. Two orthopaedic knee surgeons who were blinded measured the femur tibial rotation by measuring surgical epicondylar axes\u2014posterior tibial condyles angle (SEA\u2010PTC angle) on MRI scans.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Propensity score matching analysis yielded 19 pairs of bilateral and unilateral ACLR. The mean SEA\u2010PTC angle in the bilateral ACLR group was \u22128.6\u00b0\u2009\u00b1\u20093.9\u00b0. Specifically, the SEA\u2010PTC angle was \u22128.5\u00b0\u2009\u00b1\u20093.4\u00b0 and \u22128.7\u00b0\u2009\u00b1\u20094.4\u00b0 for right and left knee respectively. The mean SEA\u2010PTC angle in unilateral ACLR group was \u22125.2\u00b0\u2009\u00b1\u20095.8\u00b0. The SEA\u2010PTC differed statistically between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients who underwent bilateral ACLR had a significantly greater internal tibial rotation on MRI compared with those who underwent unilateral ACLR. Specifically, the mean of SEA\u2010PTC of bilateral group was about 1.5 times greater among those of unilateral ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, case\u2013control study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70496","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:49:42Z","timestamp":1761824982000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Femur tibial rotation in patients undergoing bilateral versus unilateral ACL reconstruction: A propensity score matched analysis"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3048-7764","authenticated-orcid":false,"given":"Luca","family":"Farinelli","sequence":"first","affiliation":[{"name":"Department of Clinical and Molecular Sciences Clinical Orthopaedics Universit\u00e0 Politecnica delle Marche Ancona Italy"},{"name":"IRCSS INRCA Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Di Maria","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialities Section of Orthopaedics and Traumatology Universit\u00e0 di Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Meena","sequence":"additional","affiliation":[{"name":"Gelenkpunkt \u2010 Sports and Joint Surgery Innsbruck Austria"},{"name":"Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI), Private University for Health Sciences, Medical Informatics and Technology Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"D'Ambrosi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Ortopedico Galeazzi Milan Italy"},{"name":"Universit\u00e0 Degli Dtudi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Abermann","sequence":"additional","affiliation":[{"name":"Gelenkpunkt \u2010 Sports and Joint Surgery Innsbruck Austria"},{"name":"Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI), Private University for Health Sciences, Medical Informatics and Technology Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hoser","sequence":"additional","affiliation":[{"name":"Gelenkpunkt \u2010 Sports and Joint Surgery Innsbruck Austria"},{"name":"Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI), Private University for Health Sciences, Medical Informatics and Technology Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Fink","sequence":"additional","affiliation":[{"name":"Gelenkpunkt \u2010 Sports and Joint Surgery Innsbruck Austria"},{"name":"Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI), Private University for Health Sciences, Medical Informatics and Technology Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354658701500605"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1744-1"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231153629"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-020-02763-7"},{"issue":"7","key":"e_1_2_12_7_1","first-page":"710","article-title":"Surgical epicondylar axis of the knee and its relationship to the axial tibia alignment in knee osteoarthritis: the concept of proximal twist tibia","volume":"36","author":"Farinelli L","year":"2021","journal-title":"J Knee 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