{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:54:27Z","timestamp":1791075267791,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The bone\u2013patellar tendon\u2013bone (BTB) autograft is associated with difficulty with kneeling after anterior cruciate ligament (ACL) reconstruction; however, it is unclear whether it results in a more painful or symptomatic knee compared with the hamstring tendon autograft.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To identify the rate and risk factors for knee pain and difficulty with kneeling after ACL reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Primary ACL reconstruction procedures prospectively recorded in the New Zealand ACL Registry from April 2014 to May 2021 were analyzed. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used to identify patients reporting consequential knee pain (CKP), defined as a KOOS Pain subscore of \u226472 points, and severe kneeling difficulty (SKD), defined as a self-report of \u201csevere\u201d or \u201cextreme\u201d difficulty with kneeling. Absolute values of the KOOS Pain and Symptoms subscales were also compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 10,999 patients were analyzed. At 2-year follow-up, 9.3% (420\/4492) reported CKP, and 12.0% (537\/4471) reported SKD. The most important predictor of CKP at 2-year follow-up was having significant pain before surgery (adjusted odds ratio, 4.10; P &lt; .001). The most important predictor of SKD at 2-year follow-up was the use of a BTB autograft rather than a hamstring tendon autograft (21.3% vs 9.4%, respectively; adjusted odds ratio, 3.12; P &lt; .001). There was no difference between the BTB and hamstring tendon grafts in terms of CKP (9.9% vs 9.2%, respectively; P = .494) or in absolute values of the KOOS Pain (mean, 88.7 vs 89.0, respectively; P = .37) and KOOS Symptoms (mean, 82.5 vs 82.1, respectively; P = .49) subscales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>At 2-year follow-up after primary ACL reconstruction, 9.3% of patients reported CKP, and 12.0% reported SKD. The BTB autograft was associated with difficulty with kneeling, but it did not result in a more painful or symptomatic knee compared with the hamstring tendon autograft.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465231198063","type":"journal-article","created":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T01:27:45Z","timestamp":1696037265000},"page":"3464-3472","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Comparison of Knee Pain and Difficulty With Kneeling Between Patellar Tendon and Hamstring Tendon Autografts After Anterior Cruciate Ligament Reconstruction: A Study From the New Zealand ACL Registry"],"prefix":"10.1177","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2634-3813","authenticated-orcid":false,"given":"Richard","family":"Rahardja","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamish","family":"Love","sequence":"additional","affiliation":[{"name":"Forte Sports, Christchurch, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Clatworthy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Middlemore Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0286-8052","authenticated-orcid":false,"given":"Simon W.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand"},{"name":"Department of Orthopaedic Surgery, North Shore Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"bibr1-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06443-9"},{"key":"bibr2-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1177\/03635465010290060901"},{"key":"bibr3-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.04.024"},{"key":"bibr4-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2007.00724.x"},{"key":"bibr5-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1177\/03635465030310041501"},{"key":"bibr6-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1177\/03635465030310011501"},{"key":"bibr7-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514548164"},{"key":"bibr8-03635465231198063","doi-asserted-by":"publisher","DOI":"10.3109\/17453670903350107"},{"key":"bibr9-03635465231198063","first-page":"418","volume":"92","author":"Hill GN","year":"2010","journal-title":"Orthop Proc"},{"key":"bibr10-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1136\/jisakos-2016-000110"},{"key":"bibr11-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514561745"},{"key":"bibr12-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120961082"},{"key":"bibr13-03635465231198063","doi-asserted-by":"publisher","DOI":"10.21037\/aoj.2017.05.10"},{"key":"bibr14-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000209"},{"issue":"9","key":"bibr15-03635465231198063","volume":"2011","author":"Mohtadi NG","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr16-03635465231198063","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516652888"},{"key":"bibr17-03635465231198063","unstructured":"New Zealand ACL Registry Annual Report 2017. 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