{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:06:35Z","timestamp":1789736795051,"version":"4.0.1"},"reference-count":42,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"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":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The revision rate due to postoperative instability after anterior cruciate ligament reconstruction (ACLR) remains at 4% to 25%. The physiological mechanisms of tendon-bone healing involve intricate processes, particularly neovascularization and osseointegration at the bone tunnel interface. Currently, no standardized noninvasive method exists to comprehensively evaluate tendon-bone healing progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To investigate longitudinal changes in bone mineral density (BMD) at tendon-bone interface (TBI) sites after ACLR and evaluate their associations with graft maturation and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective study enrolled 36 consecutive patients undergoing arthroscopic all-inside single-bundle ACLR using a hamstring autograft between October 2020 and October 2021. Quantitative CT assessments using phantom-less software measured BMD at femoral (anterior, posterior, proximal, and distal) and tibial (anterior, posterior, medial, and lateral) tunnel regions (entry\/mid\/exit segments) at postoperative day 1 (baseline), 6 months, 1 year, and 2 years. Graft maturity was evaluated via the signal-to-noise quotient (SNQ) on magnetic resonance imaging at 1- and 2-year follow-ups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Significant increases in volumetric BMD (vBMD) were observed at different segments and orientations in the femoral and tibial tunnel regions. From baseline to 6 months, femoral tunnel segments showed increases ranging from +36.1% to +52.7%, and tibial segments from +44.9% to +57.5% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05). From 6 months to 1 year, additional gains were observed in most regions (femoral: +22.4% to +26.1%; tibial: +15.8% to +19.2%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05). However, changes between 1 and 2 years were generally smaller (femoral: +8.6% to +12.5%; tibial: +6.9% to +19.2%) and not statistically significant in all segments and orientations (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; .05). Graft SNQ values demonstrated regional variations, with femoral tunnel areas showing higher values than tibial regions at both the 1-year and 2-year assessments. No significant changes occurred between 1- and 2-year. Negative correlations emerged between BMD changes and SNQ values in corresponding regions (femoral:\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u22120.477 to \u22120.542; tibial:\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u22120.427 to \u22120.493;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Within 2 years after ACLR, the BMD at the TBI of both femoral and tibial bone tunnels demonstrates a progressive increase. The BMD at these TBIs shows positive correlations with graft maturity at corresponding anatomic locations, providing a valuable reference for clinical assessment of tendon-bone healing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251362501","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T21:15:35Z","timestamp":1755292535000},"page":"2581-2590","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Is Bone Mineral Density at the Tendon-Bone Interface After ACL Reconstruction Associated With Graft Maturation? A Quantitative Computed Tomography Analysis"],"prefix":"10.1177","volume":"53","author":[{"given":"Wenhao","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaoming","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongliang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenfeng","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2009.04.074"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2004.05.007"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07051-x"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.5435\/jaaos-d-22-01020"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12259"},{"key":"e_1_3_2_7_2","volume-title":"Statistics in Medicine","author":"Colton T.","year":"1974","unstructured":"Colton T. 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