{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:35:02Z","timestamp":1793036102806,"version":"4.5.0"},"reference-count":30,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"unspecified","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Shandong Province medical health science and technology project","award":["202404070285"],"award-info":[{"award-number":["202404070285"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371348"],"award-info":[{"award-number":["82371348"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"China University Innovation Fund","award":["2023HT050"],"award-info":[{"award-number":["2023HT050"]}]},{"name":"China University Innovation Fund","award":["2024GR049"],"award-info":[{"award-number":["2024GR049"]}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2023MH145"],"award-info":[{"award-number":["ZR2023MH145"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,24]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Anterior cruciate ligament (ACL) injuries are among the most common sports-related injuries, often requiring surgical reconstruction to restore joint stability and function. However, inflammation and graft-to-bone healing remain critical challenges in postoperative recovery. Micro-fragmented adipose tissue (MFAT), rich in mesenchymal stem cells and anti-inflammatory factors, has shown potential in promoting tissue repair and reducing inflammation. This randomised controlled trial aims to evaluate the efficacy of MFAT injection in enhancing graft-to-bone healing at both the tibial and femoral sides and alleviating postoperative inflammation in ACL reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a prospective randomised controlled trial involving 70 patients with acute ACL injuries. Participants will be randomised into two groups: a standard ACL reconstruction group and an ACL reconstruction plus MFAT injection group. In the latter group, MFAT will be prepared from the infrapatellar fat pad and injected intra-articularly during surgery. All patients will follow a standardised postoperative rehabilitation protocol. Data will be collected at baseline and 3, 6 and 12 months postoperatively. Primary outcomes include graft maturity, assessed by signal-to-noise quotient on MRI at 6 and 12 months. Secondary outcomes include visual analogue scale scores, International Knee Documentation Committee scores and inflammatory marker levels (interleukin-6 and tumour necrosis factor-alpha). Additionally, complications such as infection and graft failure will be monitored during follow-up visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study has received ethical approval from the Ethics Committee of Weifang People\u2019s Hospital (approval number: KYLL20250105-5). Written informed consent will be obtained from all participants before enrolment. The findings will be published in peer-reviewed journals and presented at relevant conferences to contribute to evidence-based advancements in ACL reconstruction techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2500101018.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-104249","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T04:15:54Z","timestamp":1755144954000},"page":"e104249","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of injecting micro-fragmented adipose tissue (MFAT) in the tendon-bone junction region during anterior cruciate ligament reconstruction on postoperative tendon-bone healing: a protocol for a randomised controlled trial in China"],"prefix":"10.1136","volume":"15","author":[{"given":"Jun","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Joint Surgery, Weifang People's Hospital, Shandong Second Medical University, Weifang, Shandong, China"},{"name":"Department of Orthopedics, Rehabilitation hospital affiliated to National Research Center for Rehabilitation Technical Aids, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Jinhua People\u2019s Hospital, Jinhua, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiming","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjuan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Yangguangronghe Hospital, Weifang, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3947-2569","authenticated-orcid":false,"given":"Congcong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Joint Surgery, Weifang People's Hospital, Shandong Second Medical University, Weifang, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"2025123106463328000_15.8.e104249.1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ptsp.2021.12.001","article-title":"Hamstring and ACL injuries impacts on hamstring-to-quadriceps ratio of the elite soccer players: A retrospective study","volume":"53","author":"Alizadeh","year":"2022","journal-title":"Phys Ther Sport"},{"key":"2025123106463328000_15.8.e104249.2","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.knee.2021.09.003","article-title":"Anterior cruciate ligament (ACL) repair using cortical or anchor fixation with suture tape augmentation vs ACL reconstruction: A comparative biomechanical analysis","volume":"34","author":"Muench","year":"2022","journal-title":"Knee"},{"key":"2025123106463328000_15.8.e104249.3","unstructured":"Martin L , Frank M . 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