{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:09:28Z","timestamp":1790784568124,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"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":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate whether clinically failed anterior cruciate ligament (ACL) reconstructions can be accurately identified using magnetic resonance imaging (MRI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective case series included 81 patients (mean age 33.5\u2009\u00b1\u200911.9 years, 50.6% male) with clinically failed ACL reconstructions defined by Lachman\u2009\u2265\u2009Grade 2, Pivot\u2010shift\u2009\u2265\u2009Grade 2 and\/or anterior tibial translation side\u2010to\u2010side difference (ATT SSD)\u2009&gt;\u20095\u2009mm measured using a Rolimeter (Aircast\u00ae). MRI graft status was assessed using the anterior cruciate ligament Osteoarthritis Score (ACLOAS) and categorized into: Status 0\/1 (regular\/hyperintense), Status 2 (thinned\/elongated) and Status 3 (ruptured). Secondary measures comprised MRI meniscus and cartilage status, alongside baseline clinical and functional assessments, including the International Knee Documentation Committee (IKDC), Lysholm and Tegner score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Graft status was classified as Status 3 (ruptured) in 51 (63.0%) cases, while 30 (37.0%) were intact (18 [22.2%] Status 0\/1; 12 [14.8%] Status 2). Meniscus and cartilage were unremarkable in 30 (37.0%) and 31 (38.3%) cases, respectively, without significant correlation to graft status (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.135 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.846). Mean ATT SSD was 6.6\u2009\u00b1\u20091.6\u2009mm without significant group differences (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.163). Lachman Grade 2+ predominated in Status 0\/1 (14 [77.8%]), whereas Lachman Grade 3+ was more frequent in Status 2 (9 [75.0%]) and Status 3 (28 [54.9%]). Status 2 grafts showed a significant excess of Lachman Grade 3+ over Grade 2+ (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). Grade 2 pivot\u2010shift was found in majority of cases (highest in Status 0\/1 with 12 [66.7%]), while Status 2 showed the highest proportion of Grade 3 instability (4 [44.4%]). Between\u2010group differences were not statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.185). Tegner was significantly lower in Status 3 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014), while IKDC (44.5\u2009\u00b1\u200915.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.786) and Lysholm (52.2\u2009\u00b1\u200921.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.547) showed no significant group differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical failure following ACL reconstruction correlates only in 63.0% of cases with MRI\u2010based graft status. The findings indicate that clinical assessment should guide diagnosis, while MRI remains most valuable for identifying associated intra\u2010articular lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, prospective case series design.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70454","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:07:55Z","timestamp":1779275275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Limited correlation between clinical failure and MRI graft status in the setting of revision anterior cruciate ligament reconstruction"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1051-5135","authenticated-orcid":false,"given":"Mikaeil","family":"Bakhshi","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics and Sports Traumatology BG Klinikum Hamburg, Bergedorfer Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Lux","sequence":"additional","affiliation":[{"name":"Institute of Medical Data Science (IMDS), University Hospital Magdeburg Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian Michael","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics and Sports Traumatology BG Klinikum Hamburg, Bergedorfer Hamburg Germany"},{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York\u2010Presbyterian Weill Medical College of Cornell University New York New York 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5470-4981","authenticated-orcid":false,"given":"Ralph","family":"Akoto","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics and Sports Traumatology BG Klinikum Hamburg, Bergedorfer Hamburg Germany"},{"name":"Cologne Merheim Medical Center University of Witten\/Herdecke Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Eggeling","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics and Sports Traumatology BG Klinikum Hamburg, Bergedorfer Hamburg Germany"},{"name":"Department of Trauma and Orthopaedic Surgery University Medical Center Hamburg\u2010Eppendorf Hamburg 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