{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:08:03Z","timestamp":1793916483794,"version":"4.8.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2021,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The all-inside anterior cruciate ligament reconstruction (ACLR) procedure uses a single hamstring tendon folded twice and secured to itself to form a 4-stranded graft. There are several possible configurations for preparing the graft.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To investigate the biomechanical properties of a new graft preparation technique in comparison with 2 commonly used configurations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Controlled laboratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Five porcine flexor tendons were prepared into the test graft configuration: side-to-side fixation with a backup fixation at the button loop (graft M). The test configuration was compared with the results of a previous study that included grafts with simple interrupted sutures (graft A; n = 5) and end-to-end fixation (graft C; n = 5). All grafts were subjected to the same mechanical testing protocol to determine the mean failure load, stiffness, rate of elongation, and total elongation during both cyclic loading and pull to failure. Differences between groups were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Graft A had a significantly lower failure load (637 \u00b1 99 N) compared with graft M (883 \u00b1 66 N; P = .002) and graft C (846 \u00b1 26 N; P = .002). Graft A also had significantly lower stiffness (166 \u00b1 12 N\/mm) compared with graft M (215 \u00b1 8 N\/mm; P &lt; .001) and graft C (212 \u00b1 11 N\/mm; P &lt; .001). Graft C had a significantly lower elongation during cyclic loading (3.42 \u00b1 0.24 mm) compared with graft M (4.37 \u00b1 0.74 mm; P = .026) and graft A (4.90 \u00b1 0.88 mm; P = .006). The unsecured fixation was the weakest graft, with the lowest failure load and stiffness. The new side-to-side configuration and end-to-end configuration were equally strong.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The new side-to-side configuration was not biomechanically superior to the end-to-end configuration; however, they were both stronger than unsecured fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>As the all-inside ACLR is gaining popularity, this study provides surgeons with a new method of preparing grafts and evaluates the method with respect to currently used configurations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671211006521","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T10:48:57Z","timestamp":1620816537000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Biomechanical Strength of All-Inside ACL Reconstruction Grafts Using Side-to-Side and Backup Fixation"],"prefix":"10.1177","volume":"9","author":[{"given":"Lucas","family":"Graf-Alexiou","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian","family":"Karpyshyn","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonelle Jn","family":"Baptiste","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Hui","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada."},{"name":"Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sommerfeldt","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada."},{"name":"Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Westover","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,5,12]]},"reference":[{"key":"bibr1-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.10.040"},{"key":"bibr2-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120938039"},{"key":"bibr3-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2017.03.002"},{"key":"bibr4-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2014.03.028"},{"key":"bibr5-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-016-2529-2"},{"key":"bibr6-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1115\/1.1351889"},{"key":"bibr7-23259671211006521","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199904000-00013"},{"key":"bibr8-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-006-0175-x"},{"key":"bibr9-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2012.06.002"},{"key":"bibr10-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.08.025"},{"key":"bibr11-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1002\/jor.22889"},{"key":"bibr12-23259671211006521","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.08.014"},{"issue":"6","key":"bibr13-23259671211006521","first-page":"1165","volume":"32","author":"Sharma A","year":"2016","journal-title":"A systematic review. 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