{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:21:23Z","timestamp":1779286883277,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The stability of the graft in the bony tunnels is of utmost importance in the anterior cruciate ligament reconstruction (ACLR) since it ensures safe healing at the tendon\u2010bone interface. The hypothesis was that when a double tibial fixation was used in ACLR with a short graft of autologous hamstrings, tibial tunnel bone re\u2010growth and better graft integration would be observed at short\u2010term follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The analysis included a cohort of 112 patients after a primary ACLR with hamstring tendons who underwent postoperative magnetic resonance imaging (MRI) 3.0\u2010Tesla (3.0\u2010T) 6 months after the surgery. The patients were divided into three groups based on the tibial fixation technique: 40 had a screw (group S), 35 had a screw and cortical button (group S\u2009+\u2009B) and 37 had a screw and anchor (group S\u2009+\u2009A). Two orthopaedic specialists independently evaluated the images, who measured the screw\u2010free tunnel space, and assessed the presence of bone filling in the free tunnel. Furthermore, Ge's protocol was used to determine the graft healing in the tunnel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 94 patients a screw\u2010free tunnel space was detected, and a filling of the tunnel was reported in 80.85% of the cases (76 patients), being partial in 15.79% (12 patients) and complete in 84.21% (64 patients). Patients who presented better graft integration (Ge1) had significantly higher values of screw\u2010free tunnel length compared to the other ones who had lower graft integration (Ge3)(<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>At 6 months postoperative MRI, tibial tunnel bone re\u2010growth and graft\u2010tunnel tibial integration after hamstring ACLR is significantly associated with the presence of free space between the anterior tibial cortex and the most distal portion of the interference screw, hence the use of a short and proximalized interference screw is suggested to restore bone stock after hamstring ACLR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level IV retrospective comparative cohort study.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12551","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T13:09:49Z","timestamp":1734008989000},"page":"3080-3087","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Short and proximalized interference screw fixation leads to tibial tunnel bone re\u2010growth and better hamstring graft integration in ACL reconstruction"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7111-0290","authenticated-orcid":false,"given":"Francisco J.","family":"Simon\u2010Sanchez","sequence":"first","affiliation":[{"name":"Knee and Arthroscopy Unit Institut Catal\u00e0 de Traumatologia i Medicina del'Esport (ICATME)\u2010Hospital Universitari Dexeus, Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Perelli","sequence":"additional","affiliation":[{"name":"Knee and Arthroscopy Unit Institut Catal\u00e0 de Traumatologia i Medicina del'Esport (ICATME)\u2010Hospital Universitari Dexeus, Universitat Aut\u00f2noma de Barcelona Barcelona Spain"},{"name":"Department of Surgery and Morphologic Science Orthopaedic Surgery Service, Hospital del Mar, Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Pizza","sequence":"additional","affiliation":[{"name":"Knee and Arthroscopy Unit Institut Catal\u00e0 de Traumatologia i Medicina del'Esport (ICATME)\u2010Hospital Universitari Dexeus, Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelangelo","family":"Delmedico","sequence":"additional","affiliation":[{"name":"Orthopaedics and Traumatology Service ASST Papa Giovanni XXIII di Bergamo Bergamo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodolfo","family":"Morales\u2010Avalos","sequence":"additional","affiliation":[{"name":"Laboratory of Biomechanics, Department of Physiology School of Medicine, Universidad Aut\u00f3noma de Nuevo Leon Monterrey M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ra\u00fal","family":"Torres Claramunt","sequence":"additional","affiliation":[{"name":"Knee and Arthroscopy Unit Institut Catal\u00e0 de Traumatologia i Medicina del'Esport (ICATME)\u2010Hospital Universitari Dexeus, Universitat Aut\u00f2noma de Barcelona Barcelona Spain"},{"name":"Department of Surgery and Morphologic Science Orthopaedic Surgery Service, Hospital del Mar, Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan C.","family":"Monllau","sequence":"additional","affiliation":[{"name":"Knee and Arthroscopy Unit Institut Catal\u00e0 de Traumatologia i Medicina del'Esport (ICATME)\u2010Hospital Universitari Dexeus, Universitat Aut\u00f2noma de Barcelona Barcelona Spain"},{"name":"Department of Surgery and Morphologic Science Orthopaedic Surgery Service, Hospital del Mar, Universitat Aut\u00f2noma de Barcelona Barcelona 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