{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:30:21Z","timestamp":1776213021273,"version":"3.50.1"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,3,26]],"date-time":"2014-03-26T00:00:00Z","timestamp":1395792000000},"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":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate the clinical outcome of anatomical double\u2010bundle anterior cruciate ligament (ACL) reconstruction using multistranded hamstring tendons via an outside\u2010in approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and twenty\u2010one patients (mean age 28 \u00b1 10 years) who underwent ACL reconstruction were examined. Using an outside\u2010in femoral drill guide, an upper femoral tunnel for the anteromedial (AM) graft was created just below the superior articular cartilage margin of the medial wall of the lateral condyle through a small incision. A lower femoral tunnel for the posterolateral (PL) graft was drilled in the centre of the inferior\u2013posterior half of the attachment area behind the resident's ridge in the same manner. Two tibial tunnels were created at the centre of the AM and PL bundle footprints of a normal ACL. Patients were evaluated at 24\u00a0months postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>According to the IKDC form, 52\u00a0knees (43 %) were graded as normal, 64 (53 %) as nearly normal, 1 (1 %) as abnormal and 4 (3 %) as graft rupture due to re\u2010injury. Loss of knee extension of &lt;5\u00b0 was observed in one patient (1 %). Among 111 patients who were directly evaluated, none showed loss of flexion of &lt;5\u00b0. Lachman sign was negative in 103 patients (93 %), while the pivot shift test result was negative or equivalent to that of the contralateral healthy knee in 103 patients (93 %). The mean side\u2010to\u2010side difference in anterior laxity at manual maximum force with the KT\u20102000 arthrometer<jats:sup>\u00ae<\/jats:sup> was 0.9 \u00b1 1.1\u00a0mm, and 94 % of patients showed a range between \u22121 and +2\u00a0mm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The anatomical double\u2010bundle outside\u2010in ACL reconstruction provided a satisfactory short\u2010term outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Case series, Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-014-2950-4","type":"journal-article","created":{"date-parts":[[2014,3,25]],"date-time":"2014-03-25T10:25:04Z","timestamp":1395743104000},"page":"1222-1230","source":"Crossref","is-referenced-by-count":21,"title":["Outcome of anatomical double\u2010bundle ACL reconstruction using hamstring tendons via an outside\u2010in approach"],"prefix":"10.1002","volume":"23","author":[{"given":"Hiroshi","family":"Amano","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Osaka Rosai Hospital 1179\u20103, Nagasonecho, Kitaku 591\u20108025 Sakai Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiyoshi","family":"Toritsuka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Sports Medicine Kansai Rosai Hospital 3\u20101\u201069, Inabaso 660\u20100064 Amagasaki Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryohei","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Sports Medicine Kansai Rosai Hospital 3\u20101\u201069, Inabaso 660\u20100064 Amagasaki Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuo","family":"Mae","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Osaka University Graduate School of Medicine 2\u20102, 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