{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T01:17:13Z","timestamp":1773969433966,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:00:00Z","timestamp":1610668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:00:00Z","timestamp":1610668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:00:00Z","timestamp":1610668800000},"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":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to evaluate the change in cross\u2010sectional area (CSA) of bone\u2010patellar tendon\u2010bone (BTB) autografts up to 5 years after the anatomic rectangular tunnel (ART) anterior cruciate ligament reconstruction (ACLR). The changing pattern in CSA might be a potential indicator of the graft remodeling process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety\u2010six (62\u00a0males, 34 females, mean age 27.0 years) patients were enrolled in this study with a total of 220\u00a0MRI scans after ART BTB ACLR to evaluate the CSA of the ACL autografts. The patients with first time unilateral ACLR that consented to undergo MRI evaluations at postoperative periods were included in this study. Intraoperatively, the CSA of the graft was measured directly using a custom\u2010made area micrometer at the midpoint of the graft. Postoperatively, using an oblique axial slice MRI that was perpendicular to the long axis of the graft, the CSA of the graft was measured with digital radiology viewing program \u201cSYNAPSE\u201d at the midpoint of the graft. The postoperative MRI scans were classified into seven groups according to the period from ACLR to MRI evaluation: Group 0\u20132\u00a0months (m.), Group 3\u20136\u00a0m., Group 7\u201312\u00a0m., Group 1\u20132 years (y.), Group 2\u20133 y., Group 3\u20134 y., and Group 4 y.\u2010. The percent increase of the CSA was calculated by dividing the postoperative CSA by the intraoperative CSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The postoperative CSA was significantly larger than the intraoperative CSA in each group, with the exception of Group 0\u20132\u00a0m. The mean percent increase of the CSA in Group 0\u20132\u00a0m., 3\u20136\u00a0m., 7\u201312\u00a0m., 1\u20132 y., 2\u20133 y., 3\u20134 y., 4 y.\u2010 was 101.8\u2009\u00b1\u200918.2, 188.9\u2009\u00b1\u200927.4, 190.9\u2009\u00b1\u200943.7, 183.3\u2009\u00b1\u200928.9, 175.2\u2009\u00b1\u200927.9, 163.9\u2009\u00b1\u200919.8, 164.5\u2009\u00b1\u200925.4% respectively. The percent increase in Group 3\u20136\u00a0m., 7\u201312\u00a0m., 1\u20132 y., 2\u20133 y., 3\u20134 y., and 4 y.\u2010 was significantly greater than that in Group 0\u20132\u00a0m<jats:italic>.<\/jats:italic><\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The CSA of the BTB autografts after the ART BTB ACLR increases rapidly by 3\u20136\u00a0months after ACLR, reached a maximum value of 190% at around 1 year, decreases gradually after that, and reaches a plateau at around 3 years. The current study might help clinicians to estimate an individual BTB autograft's remodeling stages when considering returning patients to sports.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-06404-8","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T15:44:02Z","timestamp":1610725442000},"page":"3782-3792","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Chronological changes in cross\u2010sectional area of the bone\u2010patellar tendon\u2010bone autograft after anatomic rectangular tunnel ACL reconstruction"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6557-7802","authenticated-orcid":false,"given":"Kazutaka","family":"Kinugasa","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Sports Medicine Osaka Rosai Hospital 1179\u20103, Nagasone\u2010cho, Kita\u2010ku 591\u20108025 Sakai Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Hamada","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Hoshigaoka Medical Center 4\u20108\u20101, Hoshigaoka 573\u20108511 Hirakata Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasukazu","family":"Yonetani","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Hoshigaoka Medical Center 4\u20108\u20101, Hoshigaoka 573\u20108511 Hirakata Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Tsujii","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Hoshigaoka Medical Center 4\u20108\u20101, Hoshigaoka 573\u20108511 Hirakata Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiko","family":"Matsuo","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Orthopaedic Surgery Kansai Rosai Hospital 3\u20101\u201069, Inabaso 660\u20100064 Amagasaki Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinari","family":"Tanaka","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Sports Medicine Osaka Rosai Hospital 1179\u20103, Nagasone\u2010cho, Kita\u2010ku 591\u20108025 Sakai Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Tachibana","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Sports Medicine Osaka Rosai Hospital 1179\u20103, Nagasone\u2010cho, Kita\u2010ku 591\u20108025 Sakai Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konsei","family":"Shino","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Sports Orthopaedic Center Yukioka Hospital 2\u20102\u20103, Ukita, Kita\u2010ku 530\u20100021 Osaka Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,15]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749\u20108063(05)80313\u20105"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100040204"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010007\u20100478\u20106"},{"key":"e_1_2_10_5_2","first-page":"229","article-title":"Biology of ACL reconstructions: what happens to the graft?","volume":"45","author":"Arnoczky SP","year":"1996","journal-title":"Instr Course Lect"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010198264020\u201000011"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100070110"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109290(84)90090\u20103"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511402662"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010198163080\u201000008"},{"key":"e_1_2_10_11_2","first-page":"273","volume-title":"The analysis of variance. 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July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 December 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent from all subjects was obtained, and the appropriate institutional review board of Hoshigaoka Medical Center for human subject research approved the study protocol (ID: 1646).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}