{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T19:00:55Z","timestamp":1773601255808,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T00:00:00Z","timestamp":1596067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T00:00:00Z","timestamp":1596067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T00:00:00Z","timestamp":1596067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to quantify the effect of interference screw insertion on MPFL graft tension when securing the femoral attachment after patellar fixation. It was hypothesized that interference screw insertion significantly increases graft tension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten fresh frozen human cadaveric femurs were utilized to compare graft tension at three different preloading conditions (2\u00a0N, 5\u00a0N, 10\u00a0N) using a tensile testing machine (Admet Inc., Norwood, MA). Each preloading condition was analyzed with varying graft sizes (5\u20138\u00a0mm), tunnel diameters (7\u20139\u00a0mm), and interference screw sizes (7\u20139\u00a0mm). Non\u2010parametric statistical analysis was utilized to compare testing conditions among each other.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Graft tension significantly increased after interference screw insertion by 100% to 552%, with 2\u00a0N preload showing the greatest increase (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Grafts with a larger diameter (7\u20138\u00a0mm) had a significantly greater increase in tension than smaller grafts (5\u20136\u00a0mm), regardless of preloading conditions (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Interference screw size had no influence on graft tension (n.s.). A graft\u2010tunnel interference (tunnel diameter\u2013graft diameter) fit of 0\u00a0mm and 1\u00a0mm significantly increased graft tension for each preloading condition when compared to a slightly looser fit of\u2009\u2265\u20092\u00a0mm (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Femoral interference screw insertion significantly increases graft tension in MPFL reconstruction even in low preloading conditions, with graft size and graft\u2010tunnel interference fit having a considerably effect on graft tension. Surgeons should be aware of the inadvertent increases in graft tension even in low preloading conditions to mitigate the risk of graft overtensioning.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-06186-z","type":"journal-article","created":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T08:02:36Z","timestamp":1596096156000},"page":"2851-2856","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Femoral interference screw insertion significantly increases graft tension in medial patellofemoral ligament reconstruction"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4063-5815","authenticated-orcid":false,"given":"Jakob","family":"Ackermann","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics Balgrist University Hospital Z\u00fcrich Switzerland"},{"name":"<!--<label>2<\/label>--> Sports Medicine Center Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre Barbieri","family":"Mestriner","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Universidade Federal de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gergo","family":"Merkely","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Department of Orthopaedic Surgery, Division of Sports Medicine Center for Cartilage Repair, Brigham and Women\u2019s Hospital, Harvard Medical School Boston MA USA"},{"name":"<!--<label>5<\/label>--> Department of Traumatology Semmelweis University Budapest Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe Morlin Luiz","family":"Ambra","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Universidade Federal de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas H.","family":"Gomoll","sequence":"additional","affiliation":[{"name":"<!--<label>6<\/label>--> Hospital for Special Surgery New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,30]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101516\u2010y"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507300872"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.02.014"},{"key":"e_1_2_8_5_2","first-page":"24","article-title":"Biomechanical evaluation of lateral patellar dislocations","volume":"11","author":"Burks RT","year":"1998","journal-title":"Am J Knee 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