{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:31:07Z","timestamp":1793230267874,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,13]],"date-time":"2017-11-13T00:00:00Z","timestamp":1510531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,11,13]],"date-time":"2017-11-13T00:00:00Z","timestamp":1510531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2017,11,13]],"date-time":"2017-11-13T00:00:00Z","timestamp":1510531200000},"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.fr","clinicalkey.com.au","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate and compare the effect of preconditioning according to intraoperative workflow on the elongation behavior of single\u2010side and fully knotted all\u2010inside anterior cruciate ligament (ACL) reconstruction configurations in a biomechanical in\u00a0vitro study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four full construct all\u2010inside ACL reconstruction groups (n\u00a0= 8 per group) were tested using porcine tibias and bovine tendons. Groups included both an all\u2010inside configuration with one\u2010 (group 1) and both\u2010side knotted adjustable loop\u2010length devices (group 2), without and with performing intraoperative preconditioning (group 1\u2010intraoperative preconditioned [IPC], group 2\u2010IPC). Adjustable loop\u2010length devices for control groups were knotted according to test configurations. Intraoperative preconditioning specimens were further precycled for 10 times at 0.5\u00a0Hz and manually retensioned before knotting. All groups underwent dynamic cycling in position and force control mode each for 1,000 cycles at 0.75\u00a0Hz according to in\u00a0vitro loading parameters replicating the in\u00a0vivo ACL environment. Finally, a load\u2010to\u2010failure test at 50\u00a0mm\/min was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intraoperative preconditioning increases initial graft tension for single\u2010 (242 \u00b1 22\u00a0N vs 174 \u00b1 13\u00a0N;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001) and both\u2010side knotted configurations (225 \u00b1 15\u00a0N vs 159 \u00b1 10\u00a0N;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001) compared with controls and allows maintained graft tension at higher levels until reaching the end of position\u2010controlled cyclic loading. Furthermore, dynamic elongation is reduced for one\u2010 (1.93 \u00b1 0.28 vs 0.76 \u00b1 0.12;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001) and both\u2010side knotted (1.84 \u00b1 0.20 vs 0.96 \u00b1 0.32;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001) configurations by 61% and 47%, respectively. No intergroup (group 1 vs group 2 and group 1\u2010IPC vs group 2\u2010IPC) statistically significant differences could be found between one\u2010 and both\u2010side knotted configurations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All\u2010inside ACL reconstruction with preconditioning according to intraoperative workflow leads to a statistically significant improved mechanical behavior and may allow for optimizing initial graft tension and elongation for all\u2010inside ACL reconstruction to reduce knee laxity. A single\u2010side knotted configuration achieves similar stabilization strength to fully knotted constructs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Graft insertion until tunnel docking increases the intratunnel graft portion that may optimize graft incorporation. Eliminating a suture knot stack may improve intraoperative workflow and reduce postoperative knot irritation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2017.08.283","type":"journal-article","created":{"date-parts":[[2017,11,13]],"date-time":"2017-11-13T19:17:07Z","timestamp":1510600627000},"page":"538-545","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":28,"title":["Intraoperative Workflow for All\u2010Inside Anterior Cruciate Ligament Reconstruction: An In\u00a0Vitro Biomechanical Evaluation of Preconditioning and Knot Tying"],"prefix":"10.1002","volume":"34","author":[{"given":"Edoardo","family":"Monaco","sequence":"first","affiliation":[{"name":"Orthopaedic Unit and \u201cKirk Kilgour\u201d Sports Injury Centre S. Andrea Hospital University of Rome \u201cLa Sapienza\u201d Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Bachmaier","sequence":"additional","affiliation":[{"name":"Arthrex Department of Research &amp; Development Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Orthopaedic Unit and \u201cKirk Kilgour\u201d Sports Injury Centre S. Andrea Hospital University of Rome \u201cLa Sapienza\u201d Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo Maria","family":"Lanzetti","sequence":"additional","affiliation":[{"name":"Orthopaedic Unit and \u201cKirk Kilgour\u201d Sports Injury Centre S. Andrea Hospital University of Rome \u201cLa Sapienza\u201d Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coen A.","family":"Wijdicks","sequence":"additional","affiliation":[{"name":"Arthrex Department of Research &amp; Development Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ferretti","sequence":"additional","affiliation":[{"name":"Orthopaedic Unit and \u201cKirk Kilgour\u201d Sports Injury Centre S. 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