{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:27:38Z","timestamp":1777390058510,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2016,4,19]],"date-time":"2016-04-19T00:00:00Z","timestamp":1461024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The \u201cinitial graft tension\u201d applied at the time of graft fixation during anterior cruciate ligament (ACL) reconstruction surgery modulates joint contact mechanics, which in turn may promote posttraumatic osteoarthritis (OA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose\/Hypotheses:<\/jats:title>\n                    <jats:p>The study objectives were to compare clinical, functional, patient-reported, and OA imaging outcomes between 2 different initial laxity-based graft tension cohorts and a matched uninjured control group as well as to evaluate the effects of laxity-based graft tension on OA development at 84-month follow-up. The 2 laxity-based tension protocols were (1) to restore normal anteroposterior (AP) laxity at the time of surgery relative to the contralateral uninjured knee (low-tension group) or (2) to overconstrain AP laxity by 2 mm relative to the contralateral uninjured knee (high-tension group). The hypotheses were that (1) the high-tension group would have improved outcomes and decreased OA compared with the low-tension group after 84 months, and (2) the outcomes for the high-tension group would be equivalent to those for an age-, sex-, race-, and activity-matched group of control participants with uninjured knees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Randomized controlled trial; Level of evidence, 1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients had their ACLs reconstructed with either a bone\u2013patellar tendon\u2013bone or 4-stranded hamstring autograft, and outcomes were compared with a matched control group. Outcomes were evaluated preoperatively and at 60 and 84 months postoperatively and included clinical (KT-1000 arthrometer AP laxity measurement and International Knee Documentation Committee [IKDC] examination score), functional (1-legged hop for distance and knee extensor torque), patient-reported (Knee injury and Osteoarthritis Outcome Score [KOOS], Short Form\u201336 [SF-36], and patient satisfaction survey), and OA imaging (measurement of joint space width [JSW], Osteoarthritis Research Society International [OARSI] radiographic score, and Whole-Organ Magnetic Resonance Imaging Score [WORMS]) components. Repeated-measures analyses of variance were used to evaluate differences in outcomes between the treatment groups and the control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were significant differences between the 2 tension groups in 1 of 5 KOOS subscales (sports and recreation; P = .04) and 2 of 8 SF-36 subscales (vitality, mental health; P &lt; .04) at 84 and 60 months, respectively. Both tension groups scored significantly worse than the control group in the IKDC examination ( P &lt; .001), 1-legged hop ( P \u2264 .017), KOOS quality of life and symptoms subscales ( P &lt; .03), and OARSI radiographic score ( P \u2264 .02) at 84 months. The low-tension group performed significantly worse than the control group on the KOOS pain subscale ( P = .03), SF-36 general health and social functioning ( P &lt; .04), OARSI radiographic score ( P &lt; .001), and WORMS ( P = .001), while the high-tension group had statistically different results than the control group in AP knee laxity ( P &lt; .001), radiographic JSW ( P = .003), and OARSI radiographic score ( P = .02) as well as significantly more subsequent knee injuries ( P = .02) at 84 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The results do not support the hypotheses that the high-tension group would have improved outcomes when compared with the low-tension group after 84 months of healing or that the outcomes for the high-tension group would be equivalent to those for the matched control group. While there were minor differences in patient-reported outcomes between the 2 laxity-based tension groups, all other outcomes were similar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>NCT00434837<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546516638387","type":"journal-article","created":{"date-parts":[[2016,4,20]],"date-time":"2016-04-20T00:34:38Z","timestamp":1461112478000},"page":"1660-1670","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["Effect of Matching or Overconstraining Knee Laxity During Anterior Cruciate Ligament Reconstruction on Knee Osteoarthritis and Clinical Outcomes"],"prefix":"10.1177","volume":"44","author":[{"given":"Matthew R.","family":"Akelman","sequence":"first","affiliation":[{"name":"College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul D.","family":"Fadale","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Hulstyn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Shalvoy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Memorial Hospital of Rhode Island, Brown University, Pawtucket, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arlene","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaitlyn E.","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Duryea","sequence":"additional","affiliation":[{"name":"Department of Radiology, Brigham and Women\u2019s Hospital, Harvard University, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary J.","family":"Badger","sequence":"additional","affiliation":[{"name":"Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn A.","family":"Tung","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Braden C.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Rhode Island Hospital, Brown University, Providence, Rhode Island, 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