{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:17:50Z","timestamp":1789082270210,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,10,25]],"date-time":"2013-10-25T00:00:00Z","timestamp":1382659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>In anterior cruciate ligament (ACL) revision surgery, refilling of misplaced or enlarged tunnels frequently requires bone harvesting from the iliac crest. Unfortunately, donor\u2010site pain displays a relevant complication. In order to optimize patients\u2019 comfort, we developed a procedure combining minimally invasive intramedullary bone harvesting from the femur with arthroscopic tunnel refilling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with ACL reconstruction failure that were not eligible for one\u2010step revision surgery but required tunnel refilling prior to the next ACL reconstruction were enrolled prospectively. Cancellous bone was harvested intramedullarily from the ipsilateral femur using the reamer\u2013irrigator\u2013aspirator system in a minimally invasive manner. Afterwards, the femoral and tibial tunnels were arthroscopically refilled using cones and push rods. Computer tomography (CT) analyses were carried out before and after the filling procedure. Pain levels were assessed during the entire follow\u2010up. Patients undergoing iliac crest bone harvesting for other reasons served as a control group. Finally, the quality of the newly formed bone stock was evaluated in the subsequent ACL reconstruction procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five patients were included during a 6\u2010month period. Prior to refilling, tunnel analysis revealed a mean tunnel volume of 7.9\u00a0cm<jats:sup>3<\/jats:sup> at the femur [SD \u00b15.3\u00a0cm<jats:sup>3<\/jats:sup>] and of 6.7\u00a0cm<jats:sup>3<\/jats:sup> [SD \u00b15.1\u00a0cm<jats:sup>3<\/jats:sup>] at the tibia. The CT analyses further revealed that graft failure was predominantly caused by tunnel misplacement. Post\u2010operatively, pain levels due to intramedullary bone harvesting were significantly lower compared to iliac crest bone harvesting at every analysed time point. Three to five months after tunnel filling, CT analyses showed sufficiently incorporated bone stocks with filling rates of 75 % femoral and 94 % tibial. ACL revision surgery was performed 4\u20135\u00a0months after tunnel filling without any complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intramedullary bone harvesting from the ipsilateral femur combined with arthroscopic refilling of the bone tunnels ensures a high\u2010quality bone stock for further ACL reconstruction. The clinical relevance is shown by the feasibility of this technique and the significantly reduced pain levels during post\u2010operative recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Therapeutic study, Level III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-013-2736-0","type":"journal-article","created":{"date-parts":[[2013,10,24]],"date-time":"2013-10-24T05:34:46Z","timestamp":1382592886000},"page":"808-815","source":"Crossref","is-referenced-by-count":14,"title":["Femoral marrow cavity bone harvesting used for arthroscopic refilling of misplaced or enlarged bone tunnels in revision ACL surgery"],"prefix":"10.1002","volume":"23","author":[{"given":"S.","family":"Grote","sequence":"first","affiliation":[{"name":"Section of Arthroscopic Surgery Department of Trauma Surgery Ludwig\u2010Maximilians\u2010University Munich Campus Innenstadt, Nu\u00dfbaumstr. 20 80336 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Helfen","sequence":"additional","affiliation":[{"name":"Section of Arthroscopic Surgery Department of Trauma Surgery Ludwig\u2010Maximilians\u2010University Munich Campus Innenstadt, Nu\u00dfbaumstr. 20 80336 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"M\u00fcck","sequence":"additional","affiliation":[{"name":"Institute of Radiology Ludwig\u2010Maximilians\u2010University Munich Nu\u00dfbaumstr. 20 80336 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Regauer","sequence":"additional","affiliation":[{"name":"Section of Arthroscopic Surgery Department of Trauma Surgery Ludwig\u2010Maximilians\u2010University Munich Campus Innenstadt, Nu\u00dfbaumstr. 20 80336 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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