{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:04:35Z","timestamp":1779357875358,"version":"3.51.4"},"reference-count":55,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T00:00:00Z","timestamp":1538524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T00:00:00Z","timestamp":1538524800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T00:00:00Z","timestamp":1538524800000},"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":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To present the mid\u2010 to long\u2010term clinical and radiographic outcomes of a series of patients who underwent revision anterior cruciate ligament (ACL) reconstruction with doubled gracilis and semitendinosus (DGST) autograft and a lateral extra\u2010articular tenodesis (LET).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent revision ACL reconstruction with DGST and LET by a single surgeon between January 1997 and December 2013 were included. Revision was indicated by ACL failure noted on magnetic resonance imaging, persistent clinical instability, or laxity on clinical exam. Patients were evaluated preoperatively and at latest follow\u2010up by an independent board\u2010certified orthopaedic surgeon. Outcomes included Lachman and pivot shift tests, validated clinical and patient reported outcomes scores, and radiographic analysis. The presence of previous meniscectomy or chondral injury was recorded intraoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 118\/132 potential patients (89.4%) was available for follow\u2010up at a mean 10.6\u00a0years (3\u201019\u00a0years) postoperatively. Lachman and pivot shift examinations as well as the side\u2010to\u2010side difference on an KT\u20101000 arthrometer demonstrated significant improvement at latest follow\u2010up (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05) versus preoperative evaluation. Severe degenerative disease was present in 25% of patients on radiograph and correlated with worsened clinical outcomes. Previous meniscectomy was the only risk factor analyzed that correlated with worsened radiographic grade. No patients had a graft tear based on clinical and\/or magnetic resonance imaging evaluation, but 9 (7.6%) failed based on a side\u2010to\u2010side difference of &gt;5\u00a0mm on the KT\u20101000, a grade \u22652+ on pivot shift, or report of continued instability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Revision ACL reconstruction with DGST and LET at mid\u2010 to long\u2010term follow\u2010up provides continued improvement in clinical and radiological outcomes from preoperative assessment. Meniscectomy was the only factor related to worsened radiological grades and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2018.05.045","type":"journal-article","created":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T20:36:15Z","timestamp":1538598975000},"page":"3204-3213","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":44,"title":["Revision Anterior Cruciate Ligament Reconstruction With Hamstrings and Extra\u2010articular Tenodesis: A\u00a0Mid\u2010 to Long\u2010Term Clinical and Radiological Study"],"prefix":"10.1002","volume":"34","author":[{"given":"Andrea","family":"Redler","sequence":"first","affiliation":[{"name":"Orthopaedic Unit and Kirk Kilgour Sports Injury Centre Sant Andrea Hospital University of Rome Sapienza Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Iorio","sequence":"additional","affiliation":[{"name":"Orthopaedic Unit and Kirk Kilgour Sports Injury Centre Sant Andrea Hospital University of Rome Sapienza Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"Monaco","sequence":"additional","affiliation":[{"name":"Orthopaedic Unit and Kirk Kilgour Sports Injury Centre Sant Andrea Hospital University of Rome Sapienza Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Puglia","sequence":"additional","affiliation":[{"name":"Orthopaedic Unit and Kirk Kilgour Sports Injury Centre Sant Andrea Hospital University of Rome Sapienza Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan R.","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Connecticut Health Center Farmington Connecticut U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Mazza","sequence":"additional","affiliation":[{"name":"Orthopaedic Unit and Kirk Kilgour Sports Injury Centre Sant Andrea Hospital University of Rome Sapienza Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ferretti","sequence":"additional","affiliation":[{"name":"Orthopaedic Unit and Kirk Kilgour Sports Injury Centre Sant Andrea Hospital University of Rome Sapienza Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,3]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2008.07.005"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01618"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-006-0254-z"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513493896"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514548165"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1629-3"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512446000"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2010.02.031"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0997-4"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3414-6"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.00733"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2016.08.007"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507307391"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512471025"},{"key":"e_1_2_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507312381"},{"key":"e_1_2_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506287366"},{"key":"e_1_2_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506288015"},{"key":"e_1_2_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1765-9"},{"key":"e_1_2_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-008-0654-3"},{"key":"e_1_2_2_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510378645"},{"key":"e_1_2_2_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4449-2"},{"key":"e_1_2_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1640-8"},{"key":"e_1_2_2_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514562751"},{"key":"e_1_2_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.05.010"},{"key":"e_1_2_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.04.017"},{"key":"e_1_2_2_27_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00064"},{"key":"e_1_2_2_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2039-x"},{"key":"e_1_2_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546504269721"},{"key":"e_1_2_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2003.09.003"},{"key":"e_1_2_2_31_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198567080-00006"},{"key":"e_1_2_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.02.006"},{"key":"e_1_2_2_33_2","first-page":"142","article-title":"Lateral substitution reconstruction. Proceedings of the Canadian Orthopaedic Association","volume":"58","author":"MacIntosh D.L.","year":"1976","journal-title":"J\u00a0Bone Joint Surg Br"},{"key":"e_1_2_2_34_2","first-page":"43","article-title":"Rating systems in the evaluation of knee ligament injuries","author":"Tegner Y.","year":"1985","journal-title":"Clin Orthop Relat Res."},{"key":"e_1_2_2_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658201000306"},{"key":"e_1_2_2_36_2","first-page":"275","volume-title":"Knee surgery","author":"Anderson A.","year":"1994"},{"key":"e_1_2_2_37_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.30B4.664"},{"key":"e_1_2_2_38_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.16.4.494"},{"key":"e_1_2_2_39_2","first-page":"E89","article-title":"Revision anterior cruciate ligament reconstruction with bone\u2010patellar tendon\u2010bone allograft and extra\u2010articular iliotibial band tenodesis","volume":"44","author":"Mascarenhas R.","year":"2015","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"e_1_2_2_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516686057"},{"key":"e_1_2_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.10.004"},{"key":"e_1_2_2_42_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510395462"},{"key":"e_1_2_2_43_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514549005"},{"key":"e_1_2_2_44_2","doi-asserted-by":"crossref","DOI":"10.1177\/2325967116666039","article-title":"Predictors of revision surgery after primary anterior cruciate ligament reconstruction","volume":"4","author":"Yabroudi M.A.","year":"2016","journal-title":"Orthop J Sport Med"},{"key":"e_1_2_2_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-017-5278-9"},{"key":"e_1_2_2_46_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1601410"},{"key":"e_1_2_2_47_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-016-1894-4"},{"key":"e_1_2_2_48_2","doi-asserted-by":"publisher","DOI":"10.32098\/mltj.04.2016.10"},{"key":"e_1_2_2_49_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001670000137"},{"key":"e_1_2_2_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(04)00812-6"},{"key":"e_1_2_2_51_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199604000-00012"},{"key":"e_1_2_2_52_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659101900205"},{"key":"e_1_2_2_53_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512437722"},{"key":"e_1_2_2_54_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199604000-00011"},{"key":"e_1_2_2_55_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199604000-00013"},{"key":"e_1_2_2_56_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3406-6"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806318304833?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806318304833?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2018.05.045","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2018.05.045","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2018.05.045","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T09:15:42Z","timestamp":1773566142000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2018.05.045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,3]]},"references-count":55,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1016\/j.arthro.2018.05.045"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2018.05.045","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Revision Anterior Cruciate Ligament Reconstruction With Hamstrings and Extra-articular Tenodesis: A\u00a0Mid- to Long-Term Clinical and Radiological Study","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2018.05.045","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2018 by the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}