{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T13:45:47Z","timestamp":1792244747381,"version":"4.4.0"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"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 conduct a sex\u2010stratified analysis of factors associated with subsequent surgery for loss of motion after anterior cruciate ligament reconstruction (ACLR), including meniscus repair and graft type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      All individuals age \u226514 years who underwent primary ACLR between 2014 and 2021 were reviewed. Exclusion criteria included &lt;6 months follow\u2010up and concomitant meniscal root, multiligament, osteochondral or osteotomy procedures. The primary outcome was subsequent surgery for loss of motion. Demographic and surgical variables were compared between individuals who underwent subsequent surgery for loss of motion versus not, for the full cohort and among females and males separately. Significance was set to\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.050.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1226 individuals (age: 25\u2009\u00b1\u200910 years; 49% female) were included at a mean follow\u2010up of 2.3 years. The rate of subsequent surgery for loss of motion was 9.0% for the full cohort, 12.3% for females and 5.9% for males. Among the full cohort, female sex (OR: 2.31;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and lateral meniscus (LM) repair (OR: 1.62;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048) were predictors of subsequent surgery for loss of motion. Among females, bone\u2010patellar tendon\u2010bone (BPTB) autograft use (OR: 1.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034) and LM repair (OR: 1.72;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046) were predictors of subsequent surgery for loss of motion, with combined BPTB autograft use and LM repair resulting in a significantly higher rate of subsequent surgery for loss of motion (32% vs. 12%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). Among males, graft type and meniscus repair were not associated with subsequent surgery for loss of motion (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.050).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this sex\u2010stratified analysis, BPTB autograft use and LM repair were identified as factors predictive of subsequent surgery for loss of motion after primary ACLR when analysing females independently, while no predictive factors were identified when analysing males independently. Understanding factors associated with loss of motion after primary ACLR among males and females separately may guide individualised surgical decision\u2010making and patient counselling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70652","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T13:32:56Z","timestamp":1792243976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The use of patellar tendon autograft and lateral meniscus repair are associated with loss of motion of the knee among female patients undergoing anterior cruciate ligament reconstruction"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0397-6220","authenticated-orcid":false,"given":"Sahil","family":"Dadoo","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalie E.","family":"Nash","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zilu","family":"Yang","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Aycardi","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neel","family":"Bhardwaj","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharmesh","family":"Vyas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine Sutter Health Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Musahl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Irrgang","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, School of Health and Rehabilitation Sciences University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryson P.","family":"Lesniak","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/j.arthro.2023.01.016","article-title":"Editorial commentary: risk factors of cyclops syndrome in quadriceps autograft anterior cruciate ligament reconstruction: more helpful data in weighing graft choice","volume":"39","author":"Arner JW","year":"2023","journal-title":"Arthroscopy"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"3461","DOI":"10.1007\/s00167-019-05396-4","article-title":"Only one patient out of five achieves symmetrical knee function 6 months after primary anterior cruciate ligament reconstruction","volume":"27","author":"Cristiani R","year":"2019","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"3025","DOI":"10.1007\/s00167-020-06334-5","article-title":"Autograft type affects muscle strength and hop performance after ACL reconstruction. A randomised controlled trial comparing patellar tendon and hamstring tendon autografts with standard or accelerated rehabilitation","volume":"29","author":"Cristiani R","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.1002\/ksa.12426","article-title":"Females demonstrate lower levels of activity, psychological readiness and strength symmetry after anterior cruciate ligament reconstruction than males, and also recovery of quadriceps strength and hop symmetry is delayed in females undergoing reconstruction with a quadriceps tendon autograft","volume":"32","author":"Ebert JR","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jisako.2025.101036","article-title":"Incidence and risk factors of loss of motion following anterior cruciate ligament reconstruction: a systematic review and 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cruciate ligament reconstruction is more common in patients who are female, undergo meniscal repair, and have grafts of larger diameter","volume":"39","author":"Haley RM","year":"2023","journal-title":"Arthroscopy"},{"key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1177\/03635465231209442","article-title":"Weaker quadriceps muscle strength with a quadriceps tendon graft compared with a patellar or hamstring tendon graft at 7 months after anterior cruciate ligament reconstruction","volume":"52","author":"Holmgren D","year":"2024","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1016\/j.arthro.2023.11.006","article-title":"Female sex, older age, earlier surgery, anticoagulant use, and meniscal repair are associated with increased risk of manipulation under anesthesia or lysis of adhesions for arthrofibrosis after anterior cruciate ligament reconstruction: a systematic 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anterior cruciate ligament reconstruction","volume":"32","author":"Rahardja R","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.knee.2008.12.014","article-title":"Knee stiffness following anterior cruciate ligament reconstruction: the incidence and associated factors of","volume":"16","author":"Robertson GA","year":"2009","journal-title":"Knee"},{"key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1177\/03635465241305411","article-title":"Immunophenotyping of synovial tissue in adolescents undergoing ACL reconstruction: what is the role of synovial inflammation in arthrofibrosis?","volume":"53","author":"Romereim SM","year":"2025","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_26_1","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.1177\/0363546519854762","article-title":"Anterior cruciate ligament reconstruction in young female 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