{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T20:37:18Z","timestamp":1773607038633,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100014413","name":"Ajinomoto Animal Nutrition North America","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014413","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008542","name":"AANA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008542","id-type":"DOI","asserted-by":"publisher"}]}],"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":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The aim of the current study was to determine the effect of the knee flexion angle (KFA) during tibial anterior cruciate ligament (ACL) graft fixation on patient\u2010reported outcomes, graft stability, extension loss, and reoperation after anatomic single\u2010bundle ACL reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All 169 included patients (mean age 28.5 years, 65% male) were treated with anatomic single\u2010bundle ACL reconstruction using patellar tendon autograft and were randomized to tibial fixation of the ACL graft at either 0\u00b0 (n\u00a0= 85) or 30\u00b0 (n\u00a0= 84). The primary outcome was the Knee Injury and Osteoarthritis Outcome Score (KOOS) 2 years after surgery. Secondary outcomes were the Marx Activity Scale (MAS), the rate of reoperation, and physical examination findings at 1 year, including KT\u20101000 and side\u2010to\u2010side differences in knee extension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The follow\u2010up rate was 82% (n\u00a0= 139) for the primary outcome. Graft failure rate at 2 years was 1% (n\u00a0= 2, 1 per group). ACL tibial graft fixation at 0\u00b0 or 30\u00b0 did not have a significant effect on KOOS scores at 2 years after ACLR. Patients whose graft was fixed at a knee flexion angle of 0\u00b0 had greater scores on the MAS (mean 9.6 95% confidence interval [CI] 8.5 to 10.6, versus 8.0, 95% CI 6.9 to 9.1;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .04), and a greater proportion achieved the minimal clinical important difference (MCID) for the KOOS pain subdomain (94% versus 81%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .04). There was no significant difference in knee extension loss, KT\u20101000 measurements, or reoperation between the 2 groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the setting of anatomic single\u2010bundle ACLR using patellar tendon autograft and anteromedial portal femoral drilling, there was no difference in KOOS scores between patients fixed at 0\u00b0 and 30\u00b0. Patient fixed in full extension did demonstrate higher activity scores at 2 years after surgery and a greater likelihood of achieving the MCID for KOOS pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>II, prospective randomized trial<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2021.12.018","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T20:45:13Z","timestamp":1640119513000},"page":"1969-1977","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":14,"title":["Anterior Cruciate Ligament Patellar Tendon Autograft Fixation at 0\u00b0 Versus 30\u00b0 Results in Improved Activity Scores and a Greater Proportion of Patients Achieving the Minimal Clinical Important Difference For Knee Injury and Osteoarthritis Outcome Score Pain: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"38","author":[{"given":"Jaskarndip","family":"Chahal","sequence":"first","affiliation":[{"name":"University of Toronto Orthopaedics Sports Medicine Woman\u2019s College Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel B.","family":"Whelan","sequence":"additional","affiliation":[{"name":"University of Toronto Orthopaedics Sports Medicine Woman\u2019s College Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graeme","family":"Hoit","sequence":"additional","affiliation":[{"name":"University of Toronto Orthopaedics Sports Medicine Woman\u2019s College Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Theodoropoulos","sequence":"additional","affiliation":[{"name":"University of Toronto Orthopaedics Sports Medicine Woman\u2019s College Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabjit","family":"Ajrawat","sequence":"additional","affiliation":[{"name":"University of Toronto Orthopaedics Sports Medicine Woman\u2019s College Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Betsch","sequence":"additional","affiliation":[{"name":"University of Toronto Orthopaedics Sports Medicine Woman\u2019s College Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shgufta","family":"Docter","sequence":"additional","affiliation":[{"name":"University of Toronto Orthopaedics Sports Medicine Woman\u2019s College Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Dwyer","sequence":"additional","affiliation":[{"name":"University of Toronto Orthopaedics Sports Medicine Woman\u2019s College Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,12,21]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2014-6"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2694-6"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508320764"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.03.010"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.5792\/ksrr.16.077"},{"key":"e_1_2_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513506979"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200707000-00021"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659302100415"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508317412"},{"key":"e_1_2_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0932-8"},{"key":"e_1_2_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmart.2020.08.001"},{"key":"e_1_2_3_13_2","unstructured":"Adouni M Faisal T Dhaher Y. 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