{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T19:15:48Z","timestamp":1773602148590,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,9,10]],"date-time":"2016-09-10T00:00:00Z","timestamp":1473465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,9,10]],"date-time":"2016-09-10T00:00:00Z","timestamp":1473465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2016,9,10]],"date-time":"2016-09-10T00:00:00Z","timestamp":1473465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","arthroscopyjournal.org","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess screw divergence when inserting an interference screw for a bone\u2013patellar tendon\u2013bone graft using an outside\u2010in technique with a retrograde drill to create the femoral tunnel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Ten cadaver specimens underwent anterior cruciate ligament reconstruction with a bone\u2013patellar tendon\u2013bone autograft, with 23\u2010mm\u2010deep tunnels created by a retrograde drill outside\u2010in technique. Drilling angles were based on a previous study that established the optimal angles to recreate the anterior cruciate ligament footprint. To ensure that screw insertion angles matched the angle of socket drilling, a marking pen was used to transpose 2 lines on the skin of the anterior knee corresponding to the drill in\u00a0both the coronal and axial planes with the knee held at 90\u00b0 of flexion. The femoral\u2010sided bone plug was affixed with a 7\u00a0\u00d7 23\u00a0mm interference screw through an anteromedial portal. Computed tomography scans were used to calculate coronal and sagittal screw\u2010tunnel divergence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median screw divergence in the coronal plane was 2.79\u00b0, with a range of 1.1\u00b0 to 17.2\u00b0. Of 10 specimens, 8 had no divergence (0\u00b0 to 5\u00b0), 0 screws were between 5\u00b0 and 10\u00b0, 1 screw was between 10\u00b0 and 15\u00b0, and 1 screw was between 15\u00b0 and 20\u00b0. The 95% confidence interval was 3.73\u00b0 to 11.69\u00b0. No screws had \u226520\u00b0 of divergence. In the sagittal plane, the median screw divergence was 5.68\u00b0, with a range of 1.2\u00b0 to 18.7\u00b0. Five specimens had no divergence (0\u00b0 to 5\u00b0), 3 screws were between 5\u00b0 and 10\u00b0, 0 screws were between 10\u00b0 and 15\u00b0, and 2 screws were between 15\u00b0 and 20\u00b0 of divergence. The 95% confidence interval was 3.73\u00b0 to 11.69\u00b0. No screws had \u226520\u00b0 of divergence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results of this study showed that 80% of screws diverted less than 5\u00b0 in the coronal plane. In the sagittal plane, only 50% of screws were found to have divergence of 5\u00b0 or less. No screw in either plane had divergence of greater than or equal to 20\u00b0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>When using a retrograde drill, a skin marking technique is a useful aid in placing interference screws with acceptable angles of divergence when using an inside\u2010out technique.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2016.07.009","type":"journal-article","created":{"date-parts":[[2016,9,12]],"date-time":"2016-09-12T18:17:50Z","timestamp":1473704270000},"page":"355-361","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"title":["Femoral Screw Divergence via the Anteromedial Portal Using an Outside\u2010In Retrograde Drill in Bone\u2013Patella Tendon\u2013Bone Anterior Cruciate Ligament Reconstruction: A Cadaveric Study"],"prefix":"10.1002","volume":"33","author":[{"given":"Jason","family":"Capo","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Sports Medicine Division and Department of Radiology Musculoskeletal Division NYU Hospital for Joint Diseases New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Sports Medicine Division and Department of Radiology Musculoskeletal Division NYU Hospital for Joint Diseases New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Fralinger","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Sports Medicine Division and Department of Radiology Musculoskeletal Division NYU Hospital for Joint Diseases New York New York 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