{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:17:08Z","timestamp":1788315428209,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Combined acute femoral\u2010 and tibial\u2010side avulsion injuries of the anterior cruciate ligament (ACL) are rare and present a distinct surgical challenge because both attachment sites require restoration while preserving the native ligament tissue. This study aimed to describe an arthroscopic ACL primary repair (ACLPR) technique with suture augmentation for the treatment of rare combined acute femoral\u2010 and tibial\u2010side ACL avulsion injuries and to present its short\u2010term clinical outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 21\u2010year\u2010old male patient sustained a twisting injury to his right knee while landing during a basketball game 3\u2009weeks before presentation. He subsequently developed right knee pain and recurrent episodes of giving way and was diagnosed with combined acute femoral\u2010 and tibial\u2010side ACL avulsion tears. An arthroscopic ACLPR technique reinforced with suture augmentation was performed. The procedure involved in\u00a0situ suture capture of both avulsed ACL ends using circumferential cinch\u2010loop sutures. Femoral fixation was achieved with a polyetheretherketone (PEEK) anchor, while tibial fixation was performed through bone tunnels. A suture augmentation was incorporated to provide secondary stabilization and protect the repair during early healing. A transtibial pullout repair was performed to repair the lateral meniscus posterior root tear through a separate tibial tunnel. The surgical technique, including multi\u2010tunnel orientation, precise suture management, and secure extracortical fixation, is described in a step\u2010by\u2010step manner.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The technique allowed for anatomical reapproximation of the native ACL and stable fixation of both avulsion sites while minimizing graft harvest morbidity and optimizing biological healing conditions. At the 1\u2010year follow\u2010up, satisfactory clinical outcomes were observed, with restoration of knee stability and function, and no major complications reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Arthroscopic primary repair with suture augmentation is an optional approach for combined acute femoral and tibial attachment avulsion of the ACL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70392","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T02:52:29Z","timestamp":1785120749000},"page":"1994-2002","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Arthroscopic Primary Repair and Suture Augmentation for Combined Acute Femoral and Tibial Attachment Avulsion of Anterior Cruciate Ligament"],"prefix":"10.1111","volume":"18","author":[{"given":"Quanchao","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopaedics The First People's Hospital of Changde City  Changde Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Second Xiangya Hospital of Central South University  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchen","family":"He","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Second Xiangya Hospital of Central South University  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Second Xiangya Hospital of Central South University  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1805931"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516629944"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010022\u201007093\u20101"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102020\u2010102200"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005697\u20108"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2022.103227"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12788"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/jsa.0000000000000427"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.59124"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/burnst\/tkae079"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010014\u20102949\u2010x"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010017\u20100678\u20109"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520913532"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.09.006"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231194784"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671241253591"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jisako.2023.08.008"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2023.02.022"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2017.10.006"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2016.09.006"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/corr.0000000000000884"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2015.02.001"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2016.04.015"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2022.07.001"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2022.03.009"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2024.103034"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058\u20105241.1.160032"},{"issue":"5","key":"e_1_2_13_29_1","first-page":"716","article-title":"VI. 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