{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:38:40Z","timestamp":1777880320104,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"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":[[2022,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Radiographic and cadaveric studies have suggested that anatomic anterior cruciate ligament reconstruction (ACLR) femoral tunnel drilling with the use of a flexible reaming system through an anteromedial portal (AM-FR) may result in a different graft and femoral tunnel position compared with using a rigid reamer through an accessory anteromedial portal with hyperflexion (AAM-RR). No prior studies have directly compared clinical outcomes between the use of these 2 techniques for femoral tunnel creation during ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To compare revision rates at a minimum of 2 years postoperatively for patients who underwent ACLR with AM-FR versus AAM-RR. The secondary objectives were to compare functional testing and patient-reported outcomes between the cohorts.<\/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>Included were consecutive patients at a single academic institution between 2013 and 2018 who underwent primary ACLR without additional ligamentous reconstruction. Patients were separated into 2 groups based on the type of anatomic femoral tunnel drilling: AM-FR or AAM-RR. Graft failure, determined by revision ACLR, was assessed with a minimum 2 years of postoperative follow-up. The authors also compared patient-reported outcome scores (International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS]) and functional performance testing performed at 6 months postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 284 (AAM-RR, 232; AM-FR, 52) patients were included. The mean follow-up time was 3.7 \u00b1 1.5 years, with a minimum 2-year follow-up rate of 90%. There was no significant difference in the rate of revision ACLR between the AAM-RR and AM-FR groups (10.8% vs 9.6%, respectively; P = .806). At 6 months postoperatively, there were no significant between-group differences in peak knee extension strength, peak knee flexion strength, limb symmetry indices, or hop testing, as well as no significant differences in IKDC (AAM-RR, 81.1; AM-FR, 78.9; P = .269) or KOOS (AAM-RR, 89.0; AM-FR, 86.7; P = .104).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this limited study, independent femoral tunnel drilling for ACLR using rigid or flexible reaming systems resulted in comparable rates of revision ACLR at a minimum of 2 years postoperatively, with no significant differences in strength assessments or patient-reported outcomes at 6 months postoperatively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671221083568","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T10:43:58Z","timestamp":1647427438000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Flexible Versus Rigid Reaming Systems for Independent Femoral Tunnel Reaming During ACL Reconstruction: Minimum 2-Year Clinical Outcomes"],"prefix":"10.1177","volume":"10","author":[{"given":"Thomas E.","family":"Moran","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony J.","family":"Ignozzi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric R.","family":"Taleghani","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amelia S.","family":"Bruce","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M.","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian C.","family":"Werner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,3,16]]},"reference":[{"key":"bibr1-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1007\/s001670100198"},{"key":"bibr2-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1248210"},{"key":"bibr3-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509357608"},{"key":"bibr4-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20632"},{"key":"bibr5-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.03.008"},{"key":"bibr6-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4399-0"},{"key":"bibr7-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1177\/2325967115592875"},{"key":"bibr8-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.11.004"},{"key":"bibr9-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511420128"},{"key":"bibr10-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1136\/jisakos-2015-000001"},{"key":"bibr11-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.09.040"},{"key":"bibr12-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3670-0"},{"key":"bibr13-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510370929"},{"key":"bibr14-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.01.021"},{"key":"bibr15-23259671221083568","doi-asserted-by":"publisher","DOI":"10.14517\/aosm14021"},{"key":"bibr16-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05709-7"},{"key":"bibr17-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.12.015"},{"key":"bibr18-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211035741"},{"key":"bibr19-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3181-4"},{"key":"bibr20-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.09.009"},{"key":"bibr21-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.01.055"},{"key":"bibr22-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.01.018"},{"key":"bibr23-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520906158"},{"key":"bibr24-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-1-64"},{"key":"bibr25-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-017-5278-9"},{"key":"bibr26-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2009.10.012"},{"key":"bibr27-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509340407"},{"key":"bibr28-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.11.029"},{"key":"bibr29-23259671221083568","doi-asserted-by":"publisher","DOI":"10.2174\/1874325001610010481"},{"key":"bibr30-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.01.041"},{"key":"bibr31-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-019-0198-0"},{"key":"bibr32-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510378645"},{"key":"bibr33-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-020-03343-4"},{"key":"bibr34-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-004-0541-5"},{"key":"bibr35-23259671221083568","doi-asserted-by":"publisher","DOI":"10.1590\/S0102-86502012000800010"}],"container-title":["Orthopaedic Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671221083568","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259671221083568","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671221083568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:07:54Z","timestamp":1777594074000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259671221083568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3,1]]}},"alternative-id":["10.1177\/23259671221083568"],"URL":"https:\/\/doi.org\/10.1177\/23259671221083568","relation":{},"ISSN":["2325-9671","2325-9671"],"issn-type":[{"value":"2325-9671","type":"print"},{"value":"2325-9671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,1]]},"article-number":"23259671221083568"}}