{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:25:07Z","timestamp":1786969507861,"version":"build-2736575974"},"reference-count":72,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"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>Anterior cruciate ligament (ACL) injuries are increasing in children and adolescents and reconstruction (ACLR) is now frequently performed in this population. Paediatric patients remain at higher risk of reinjury, possibly due to delayed graft remodelling. The current study aims to compare magnetic resonance imaging (MRI)\u2010based graft remodelling between paediatric and adult populations at 1 year postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010centre comparative pilot study including a prospectively collected cohort of 52 paediatric and 59 adult patients undergoing ACLR with a semitendinosus autograft folded in four (ST4) without additional lateral extra\u2010articular tenodesis (LET). MRI was performed at 12 months postoperatively. Graft maturation was assessed using the signal\u2010to\u2010noise quotient (SNQ) and Howell scores. Tibial tunnel widening (TTW) and patient\u2010reported outcome measures (PROMs) were also collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean adjusted SNQ was significantly higher (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) in paediatric patients (5.1; 95% confidence interval [CI] [4.3\u20135.9]) than in adults (1.5; 95% CI [0.9\u20132.2]), indicating slower remodelling. The Howell classification confirmed less mature grafts in children, with a predominance of Grade II. TTW was observed in similar proportions in both groups. PROMs were favourable and comparable in both groups. One paediatric patient experienced a graft rupture at 6 months, following premature return to pivoting sport.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At 1\u2010year post\u2010ACLR, paediatric patients show delayed graft remodelling compared to adults. This slower biological incorporation may contribute to higher reinjury rates in young athletes and supports the need for prolonged rehabilitation and careful return to high\u2010risk sports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70576","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:29:53Z","timestamp":1786966193000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hamstring graft remodelling after ACL reconstruction is slower in paediatric population compared to adults"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7767-5395","authenticated-orcid":false,"given":"Caroline","family":"de Pesters","sequence":"first","affiliation":[{"name":"Department of Orthopaedics H\u00f4pital des Enfants, CHU de Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2150-8391","authenticated-orcid":false,"given":"Nicolas","family":"Vari","sequence":"additional","affiliation":[{"name":"Musculoskeletal Institute H\u00f4pital Pierre\u2010Paul Riquet, CHU de Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"B\u00e9rard","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Public Health CERPOP, INSERM\u2010University of Toulouse III, Toulouse University Hospital (CHU) Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Maupoint","sequence":"additional","affiliation":[{"name":"Department of Radiology H\u00f4pital des Enfants, CHU de Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Staali","sequence":"additional","affiliation":[{"name":"Department of Radiology H\u00f4pital des Enfants, CHU de Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2687-959X","authenticated-orcid":false,"given":"Marie","family":"Faruch","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Radiology H\u00f4pital Pierre\u2010Paul Riquet, CHU de Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1043-7567","authenticated-orcid":false,"given":"Etienne","family":"Cavaignac","sequence":"additional","affiliation":[{"name":"Musculoskeletal Institute H\u00f4pital Pierre\u2010Paul Riquet, CHU de Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5366-3885","authenticated-orcid":false,"given":"Franck","family":"Accadbled","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics H\u00f4pital des Enfants, CHU de Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"issue":"5","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/BPO.0000000000002888","article-title":"Knee anterior laxity and graft maturation after transphyseal anterior cruciate ligament reconstruction","volume":"45","author":"Accadbled F","year":"2025","journal-title":"J Pediatr Orthop"},{"issue":"6","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1007\/s00402-021-03971-4","article-title":"Radiological maturation and clinical results of double\u2010bundle and single\u2010bundle anterior cruciate ligament reconstruction. 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