{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:02:46Z","timestamp":1789678966502,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"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 evaluate magnetic resonance imaging (MRI)\u2010based continuity and signal characteristics of reconstructed anterolateral ligament (ALL) grafts and compare anteroposterior and rotational knee laxity after anterior cruciate ligament (ACL) graft failure with values recorded before the index combined ACL\u2013ALL reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective case series included 15 patients who experienced ACL graft failure after combined ACL\u2013ALL reconstruction; the index combined procedure was primary in 12 patients and a revision in 3. MRI was reviewed to assess ALL graft continuity, intrinsic signal changes and periligamentous edema. Side\u2010to\u2010side anterior tibial translation (ATT) measured with the KT\u20101000 arthrometer and pivot\u2010shift grade were compared between the preindex reconstruction assessment and the assessment after ACL graft failure using Wilcoxon signed\u2010rank tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ACL graft failure occurred at a mean of 22\u2009\u00b1\u20091.5 months (range, 18\u201324 months) after the index reconstruction. The ALL graft showed preserved continuity on MRI in all 15 patients (100%), and mild signal changes were observed in 9 (60%). Median ATT was lower after ACL graft failure than before the index reconstruction (5 vs. 7\u2009mm; median paired reduction, 2\u2009mm [IQR, 1\u20133];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Median pivot\u2010shift grade was also lower (1 vs. 2; median paired reduction, 1 grade [IQR, 1\u20131.5];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). ATT and pivot\u2010shift grade improved in 12 of 15 patients (80%), and no patient demonstrated a high\u2010grade pivot shift after ACL graft failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following ACL graft failure after combined ACL\u2013ALL reconstruction, MRI showed preserved ALL graft continuity in all cases, and knee laxity was lower than before the index reconstruction. In this setting, physical examination findings should be interpreted cautiously because anteroposterior and rotational laxity may be lower than expected. The retrospective design and small, heterogeneous sample preclude causal attribution to the ALL graft and any conclusion that anterolateral revision can be omitted.<\/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\/ksa.70618","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:11:01Z","timestamp":1789675861000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preserved anterolateral ligament graft continuity on MRI and lower knee laxity after ACL graft failure than before index combined ACL\u2013ALL reconstruction: A retrospective case series"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3164-9449","authenticated-orcid":false,"given":"Renata Vidal","family":"Le\u00e3o","sequence":"first","affiliation":[{"name":"Department of Radiology, Musculoskeletal Division University of Iowa Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8422-8165","authenticated-orcid":false,"given":"Debora Mayumi","family":"Takamune","sequence":"additional","affiliation":[{"name":"Institute of Radiology Hospital S\u00edrio\u2010Liban\u00eas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2358-7508","authenticated-orcid":false,"given":"Andre Giardino Moreira","family":"da Silva","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Institute of Orthopaedics and Traumatology University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0110-4476","authenticated-orcid":false,"given":"Gabriela Ribeiro","family":"Camerin","sequence":"additional","affiliation":[{"name":"Department of Radiology, Musculoskeletal Division University of Iowa Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5702-1529","authenticated-orcid":false,"given":"Diego","family":"Ariel de Lima","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Universidade Federal Rural do Semi\u2010\u00c1rido (UFERSA) Mossor\u00f3 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1139-2524","authenticated-orcid":false,"given":"Camilo Partezani","family":"Helito","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Institute of Orthopaedics and Traumatology University of S\u00e3o Paulo S\u00e3o Paulo 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