{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:35:19Z","timestamp":1787614519911,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,12,16]],"date-time":"2014-12-16T00:00:00Z","timestamp":1418688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,12,16]],"date-time":"2014-12-16T00:00:00Z","timestamp":1418688000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2014,12,16]],"date-time":"2014-12-16T00:00:00Z","timestamp":1418688000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2014,12,16]],"date-time":"2014-12-16T00:00:00Z","timestamp":1418688000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine the effect of differing postoperative immobilization periods on femoral bone tunnel enlargement and clinical outcome after double\u2010bundle anterior cruciate ligament (ACL) reconstruction with hamstring grafts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty\u2010one patients undergoing primary double\u2010bundle ACL reconstruction with hamstring grafts were divided into 3 postoperative immobilization protocol groups: 2\u2010day immobilization with the knee in 20\u00b0 of flexion postoperatively (group A, n\u00a0= 18); 1\u2010week immobilization (group B, n\u00a0= 17); and 2\u2010week immobilization (group C, n\u00a0= 16). Bone tunnel enlargement was determined by computed digital radiographs taken on the first postoperative day and at 24 months in the anteroposterior (AP) and lateral views. Each tunnel diameter was shown as a percentage of the maximum joint width of the proximal tibia on the AP view or a percentage of the maximum diameter of the patella on the lateral view. To determine the incidence of tunnel enlargement, a percentage diameter change of more than 10% was defined as an enlarged tunnel. The standard clinical evaluation was also performed. This study used nonrandomized procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In each group there were no significant differences in the incidence and magnitude of anteromedial and posterolateral bone tunnel enlargement on both the AP and lateral views (1\u2010factor analysis of variance). Group C showed significantly less muscle strength in knee extension compared with the contralateral knee (85.3% \u00b1 18.4%) than group A (93.7% \u00b1 13.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .049) and group B (96.8% \u00b1 12.9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .044).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This prospective radiographic study showed that femoral bone tunnel enlargement, in both the anteromedial and posterolateral tunnels, may occur after double\u2010bundle ACL reconstruction with hamstring grafts despite different postoperative immobilization periods, with no significant difference in the incidence and magnitude among groups with differing postoperative immobilization periods. In addition, a 2\u2010week immobilization period after surgery showed harmful effects, such as significantly less quadriceps muscle strength.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, prospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2014.10.015","type":"journal-article","created":{"date-parts":[[2014,12,16]],"date-time":"2014-12-16T08:46:29Z","timestamp":1418719589000},"page":"651-658","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":15,"title":["Prospective Comparisons of Femoral Tunnel Enlargement With 3 Different Postoperative Immobilization Periods After Double\u2010Bundle Anterior Cruciate Ligament Reconstruction With Hamstring\u00a0Grafts"],"prefix":"10.1002","volume":"31","author":[{"given":"Takuya","family":"Tajima","sequence":"first","affiliation":[{"name":"Division of Orthopedic Surgery Department of Medicine of Sensory and Motor Organs Faculty of Medicine University of Miyazaki Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuo","family":"Chosa","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Surgery Department of Medicine of Sensory and Motor Organs Faculty of Medicine University of Miyazaki Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhiro","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Surgery Department of Medicine of Sensory and Motor Organs Faculty of Medicine University of Miyazaki Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nami","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Division of 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