{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:02:24Z","timestamp":1781222544447,"version":"3.54.1"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Tunnel malposition is a frequent complication of anterior cruciate ligament (ACL) reconstruction. We evaluated whether the tibial tunnel location of patients who underwent anatomical single-bundle ACL reconstruction with hamstring tendons affected knee stability, muscle strength, and clinical outcomes. We retrospectively evaluated operated and normal knee magnetic resonance imaging (MRI) scans of 34 patients who underwent anatomical single-bundle ACL reconstruction technique with hamstring tendons. Tibial tunnel location was measured according to two techniques: anatomical landmarks of the tibial footprint and contralateral normal knee ACL anatomical scans. The effect of tibial tunnel location on knee stability, isokinetic and single-leg hop test (SLHT) results, and Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC-2000) scores was evaluated. For tunnel position evaluated by anatomical landmark methods, patients were defined as regular footprint in 23 patients, anterior in 5, and posterior in 6. Similarly, tibial tunnel positions evaluated by contralateral footprint: 20 patients were grouped as regular, 4 as anterior, 6 as posterior, and 4 as medial tibial tunnel position. Groups were compared according to both techniques. KOOS pain scores were significantly different in posterior tunnel position patients compared to patients with regular position (p\u2009=\u20090.023). No significant difference was found between the pivot shift, Kneelax 3 anterior translation, and SLHT, and leg symmetry index (LSI). Isokinetic test results and IKDC and other KOOS scores of all groups were similar. The kappa value between two measurement techniques was 0.681, and the agreement between techniques was 82% (p\u2009&lt;\u20090.001). Tibial tunnel position may not be optimal because of technical reasons. Tunnel malposition does not significantly affect the stability and clinical outcomes of the patients in mid-term results. We can evaluate the tibial tunnel only with the operated knee's routine control MRI scans.<\/jats:p>","DOI":"10.1055\/a-2886-7914","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T22:40:37Z","timestamp":1780612837000},"source":"Crossref","is-referenced-by-count":0,"title":["Does Tibial Tunnel Placement Affect Postoperative Function and Isokinetic Outcomes in Patients Undergoing Anatomical Single-Bundle Anterior Cruciate Ligament Reconstruction with Hamstring Autograft?"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5166-7708","authenticated-orcid":false,"given":"Emrah","family":"Arslanta\u015f","sequence":"additional","affiliation":[{"name":"Aksaray University, Turkey","department":["Faculty of Medicine, Department of Orthopedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alper","family":"Deveci","sequence":"additional","affiliation":[{"name":"Ankara Ortadogu Hospital, Turkey","department":["Department of Orthopedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guzelali","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"Ankara City Hospital, Turkey","department":["Department of Orthopedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olgun","family":"Bingol","sequence":"additional","affiliation":[{"name":"Ankara City Hospital, Turkey","department":["Department of Orthopedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niyazi Erdem","family":"Yasar","sequence":"additional","affiliation":[{"name":"Ankara City Hospital, Turkey","department":["Department of Orthopedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal","family":"Andic","sequence":"additional","affiliation":[{"name":"Bilecik Seyh Edebali University, Turkey","department":["Department of Orthopedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.knee.2006.01.005","article-title":"Epidemiology of athletic knee injuries: a 10-year study","volume":"13","author":"M Majewski","year":"2006","journal-title":"Knee"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.csm.2016.08.013","article-title":"Graft selection in anterior cruciate ligament surgery: who gets what and why?","volume":"36","author":"K R Duchman","year":"2017","journal-title":"Clin Sports Med"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"2341","DOI":"10.1177\/0363546518782454","article-title":"No difference in the KOOS quality of life subscore between anatomic double-bundle and anatomic single-bundle anterior cruciate ligament reconstruction of the knee: a prospective randomized controlled trial with 2 years' follow-up","volume":"46","author":"C Aga","year":"2018","journal-title":"Am J Sports Med"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s13018-018-0753-x","article-title":"Single-bundle versus double-bundle autologous anterior cruciate ligament reconstruction: a meta-analysis of randomized controlled trials at 5-year minimum follow-up","volume":"13","author":"H Chen","year":"2018","journal-title":"J Orthop Surg Res"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.aott.2018.12.004","article-title":"Long term results after double and single bundle ACL reconstruction: Is there any difference? 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