{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T15:24:35Z","timestamp":1774452275930,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100002642","name":"Korea University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002642","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002642","name":"Korea University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002642","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":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine the relationship between patient\u2010reported outcomes (PROs), objective graft status on second\u2010look arthroscopy, and knee muscle strength during the early period after isolated primary anterior cruciate ligament reconstruction (ACLR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent second\u2010look arthroscopy at least 1 year after primary ACLR between 2012 and 2020 were retrospectively reviewed. Those who completed follow\u2010up muscle strength tests and PRO measures were included in this study. Subjective clinical outcomes were assessed on the basis of patient\u2010reported outcome measures using the Lysholm score preoperatively and during second\u2010look arthroscopy. Objective graft status was assessed during second\u2010look arthroscopy using a numeric scale system consisting of the following 4 subscales: tension, vascularity, synovialization, and continuity of the graft. The graft score (0\u20108) was determined by adding the points from each subscale (0\u20102). Muscle strength was measured using isokinetic dynamometry to assess peak torque, limb symmetry index for both the quadriceps and hamstrings and the ratio of the hamstring and quadriceps before second\u2010look arthroscopy. Second\u2010look arthroscopy patients included in analysis were those without concomitant meniscal or cartilage procedures. Multivariate logistic regression was used to identify factors associated with inferior PROs (Lysholm score \u226483).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 82 patients were enrolled in this study. At an average follow\u2010up of 22.4 \u00b1 4.8 months, 25 patients (30.5%) scored less than 83 on the Lysholm scale. No significant differences were found in total graft status scores between groups with superior or inferior outcomes (6.9 \u00b1 1.8 vs 7.1 \u00b1 1.2,\n                      <jats:italic>P<\/jats:italic>\n                      = .573). However, the group with inferior PROs showed significantly lower peak torque in both hamstring and quadriceps (\n                      <jats:italic>P<\/jats:italic>\n                      = .001 and\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001, respectively). Multivariate analysis indicated that older age and lower limb symmetry index for extension and flexion (&lt;70% and 90%, respectively) were significantly correlated with inferior PROs (odds ratios: 1.08, 5.11, and 5.66;\n                      <jats:italic>P<\/jats:italic>\n                      = .014, .013, and .006, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early inferior subjective outcomes after ACLR were associated with delayed recovery of quadriceps and hamstring muscle strength compared to graft appearance and tension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2025.02.031","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T12:31:21Z","timestamp":1741264281000},"page":"4008-4018","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lower Patient\u2010Reported Outcomes After Isolated Anterior Cruciate Ligament Reconstruction Are Associated With Lower Muscle Strength Rather Than Graft Status During Second\u2010Look Arthroscopic Evaluation"],"prefix":"10.1002","volume":"41","author":[{"given":"Seo\u2010Jun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Korea University Anam Hospital Korea University College of Medicine Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun\u2010Gu","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Korea University Anam Hospital Korea 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