{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T01:21:25Z","timestamp":1783473685615,"version":"3.55.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Applying pretension by cyclic knee motion immediately before graft fixation in anterior cruciate ligament (ACL) reconstruction surgery decreases graft elongation during the postoperative course. However, the expected change in graft tension caused by cyclic knee motion remains unclear. We measured graft tension changes caused by cyclic knee motion during double-bundle ACL reconstruction.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We included 39 patients undergoing primary anatomical double-bundle ACL reconstruction with autologous hamstrings as graft sources, at multiple centers between February 2021 and August 2022. After securing the anteromedial (AM) and posterolateral (PL) bundle grafts to the femoral cortex, they were initially tensioned to 40\u2009N per bundle. After 10 cycles of knee extension and flexion motion, ranging from 0 to 90\u2013110\u00b0, tension was re-measured and re-tensioned to 40\u2009N if the graft tension had decreased. This was repeated thrice for 10\u2009cycles on each graft. Every 10 cycles, we recorded graft tension changes (\u0394GT) and compared the mean \u0394GT in the AM and PL bundles. Furthermore, we assessed relationships between total \u0394GT in each bundle, age, sex, and graft diameter.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Twenty-five women and 14 men with a mean age of 27.4\u2009\u00b1\u200912.4\u2009years were included. The mean \u0394GT in AM and PL bundles after every 10 cycles were 6.6\u2009\u00b1\u20093.7\u2009N, 3.0\u2009\u00b1\u20092.3\u2009N, 1.4\u2009\u00b1\u20091.5\u2009N, and 9.9\u2009\u00b1\u20093.8\u2009N, 4.9\u2009\u00b1\u20092.6\u2009N, and 2.5\u2009\u00b1\u20091.9\u2009N, respectively. There were significant differences in \u0394GT in both bundles after every 10 cycles (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). \u0394GT in the AM bundle was significantly lower than in the PM bundle at the same number of cycles (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). No correlation was observed between \u0394GT in either bundle and age, sex, or graft diameter.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The initially applied graft tension decreased by intra-operative cyclic knee movement, and the changes in graft tension decreased after retention and repeated cycles. Three sets of 10\u2009cycles knee motion may avoid initial tension loss of the hamstring autograft in the early phase after double-bundle ACL reconstruction.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12891-024-07239-x","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T13:02:28Z","timestamp":1707138148000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Number of intra-operative cyclic knee motion required to achieve stable graft tension in anterior cruciate ligament reconstruction; a prospective clinical study"],"prefix":"10.1186","volume":"25","author":[{"given":"Manato","family":"Horii","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichiro","family":"Akagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shotaro","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Enomoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Hosokawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Ohtori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahisa","family":"Sasho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"issue":"1","key":"7239_CR1","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1053\/j.oto.2004.11.003","volume":"15","author":"LS Beasley","year":"2005","unstructured":"Beasley LS, Weiland DE, Vidal AF, Chhabra A, Herzka AS, Feng MT, et al. Anterior cruciate ligament reconstruction: a literature review of the anatomy, biomechanics, surgical considerations, and clinical outcomes. Oper Tech Orthop. 2005;15(1):5\u201319. https:\/\/doi.org\/10.1053\/j.oto.2004.11.003.","journal-title":"Oper Tech Orthop"},{"issue":"6","key":"7239_CR2","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1177\/0363546508314433","volume":"36","author":"T Mae","year":"2008","unstructured":"Mae T, Shino K, Nakata K, Toritsuka Y, Otsubo H, Fujie H. Optimization of graft fixation at the time of anterior cruciate ligament reconstruction. Part I: effect of initial tension. Am J Sports Med. 2008;36(6):1087\u201393. https:\/\/doi.org\/10.1177\/0363546508314433.","journal-title":"Am J Sports Med"},{"issue":"9","key":"7239_CR3","doi-asserted-by":"publisher","first-page":"1756","DOI":"10.1016\/j.arthro.2015.03.012","volume":"31","author":"H Koga","year":"2015","unstructured":"Koga H, Muneta T, Yagishita K, Watanabe T, Mochizuki T, Horie M, et al. Effect of initial graft tension on knee stability and graft tension pattern in double-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2015;31(9):1756\u201363. https:\/\/doi.org\/10.1016\/j.arthro.2015.03.012.","journal-title":"Arthroscopy."},{"issue":"3","key":"7239_CR4","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/s0749-8063(96)90060-2","volume":"12","author":"ME Howard","year":"1996","unstructured":"Howard ME, Cawley PW, Losse GM, Johnston RB. Bone-patellar tendon-bone grafts for anterior cruciate ligament reconstruction: the effects of graft pretensioning. Arthroscopy. 1996;12(3):287\u201392. https:\/\/doi.org\/10.1016\/s0749-8063(96)90060-2.","journal-title":"Arthroscopy."},{"issue":"1","key":"7239_CR5","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1186\/s12891-019-2699-5","volume":"20","author":"D Jiang","year":"2019","unstructured":"Jiang D, Ao YF, Jiao C, Guo QW, Xie X, Zhao F, et al. The effect of cyclic knee motion on the elongation of four-strand hamstring autograft in anterior cruciate ligament reconstruction: an in-situ pilot study. BMC Musculoskelet Disord. 2019;20(1):321. https:\/\/doi.org\/10.1186\/s12891-019-2699-5.","journal-title":"BMC Musculoskelet Disord"},{"key":"7239_CR6","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.asmart.2018.01.002","volume":"12","author":"T Sasho","year":"2018","unstructured":"Sasho T, Sasaki T, Hoshi H, Akagi R, Enomoto T, Sato Y, et al. Evaluating different closed loop graft preparation technique for tibial suspensory fixation in ACL reconstruction using TightRope\u2122. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2018;12:5\u201311. https:\/\/doi.org\/10.1016\/j.asmart.2018.01.002.","journal-title":"Asia Pac J Sports Med Arthrosc Rehabil Technol"},{"issue":"5","key":"7239_CR7","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1016\/j.arthro.2005.01.013","volume":"21","author":"CH Lee","year":"2005","unstructured":"Lee CH, Huang GS, Chao KH, Wu SS, Chen Q. Differential pretensions of a flexor tendon graft for anterior cruciate ligament reconstruction: a biomechanical comparison in a porcine knee model. Arthroscopy. 2005;21(5):540\u20136. https:\/\/doi.org\/10.1016\/j.arthro.2005.01.013.","journal-title":"Arthroscopy."},{"issue":"9","key":"7239_CR8","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.1016\/j.arthro.2010.03.014","volume":"26","author":"K Yasuda","year":"2010","unstructured":"Yasuda K, Tanabe Y, Kondo E, Kitamura N, Tohyama H. Anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2010;26(9):S21\u201334. https:\/\/doi.org\/10.1016\/j.arthro.2010.03.014.","journal-title":"Arthroscopy."},{"issue":"8","key":"7239_CR9","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1016\/j.arthro.2009.12.019","volume":"26","author":"R Siebold","year":"2010","unstructured":"Siebold R, Cafaltzis K. Differentiation between intraoperative and postoperative bone tunnel widening and communication in double-bundle anterior cruciate ligament reconstruction: a prospective study. Arthroscopy. 2010;26(8):1066\u201373. https:\/\/doi.org\/10.1016\/j.arthro.2009.12.019.","journal-title":"Arthroscopy."},{"issue":"4","key":"7239_CR10","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1016\/j.knee.2015.04.016","volume":"22","author":"MJ Boyle","year":"2015","unstructured":"Boyle MJ, Vovos TJ, Walker CG, Stabile KJ, Roth JM, Garrett WE. Does adjustable-loop femoral cortical suspension loosen after anterior cruciate ligament reconstruction? A retrospective comparative study. Knee. 2015;22(4):304\u20138. https:\/\/doi.org\/10.1016\/j.knee.2015.04.016.","journal-title":"Knee."},{"issue":"4","key":"7239_CR11","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1177\/0363546504269938","volume":"33","author":"MP Arnold","year":"2005","unstructured":"Arnold MP, Lie DTT, Verdonschot N, De Graaf R, Amis AA, Van Kampen A. The remains of anterior cruciate ligament graft tension after cyclic knee motion. Am J Sports Med. 2005;33(4):536\u201342. https:\/\/doi.org\/10.1177\/0363546504269938.","journal-title":"Am J Sports Med"},{"issue":"2","key":"7239_CR12","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1177\/0363546506294571","volume":"35","author":"T Zantop","year":"2007","unstructured":"Zantop T, Herbort M, Raschke MJ, Fu FH, Petersen W. The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med. 2007;35(2):223\u20137. https:\/\/doi.org\/10.1177\/0363546506294571.","journal-title":"Am J Sports Med"},{"issue":"3","key":"7239_CR13","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/j.arthro.2012.10.018","volume":"29","author":"H Koga","year":"2013","unstructured":"Koga H, Muneta T, Yagishita K, Ju YJ, Mochizuki T, Horie M, et al. Effect of posterolateral bundle graft fixation angles on graft tension curves and load sharing in double-bundle anterior cruciate ligament reconstruction using a transtibial drilling technique. Arthroscopy. 2013;29(3):529\u201338. https:\/\/doi.org\/10.1016\/j.arthro.2012.10.018.","journal-title":"Arthroscopy."},{"issue":"3","key":"7239_CR14","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1177\/0363546511426696","volume":"40","author":"H Koga","year":"2012","unstructured":"Koga H, Muneta T, Yagishita K, Ju Y-J, Sekiya I. The effect of graft fixation angles on anteroposterior and rotational knee laxity in double-bundle anterior cruciate ligament reconstruction: evaluation using computerized navigation. Am J Sports Med. 2012;40(3):615\u201323. https:\/\/doi.org\/10.1177\/0363546511426696.","journal-title":"Am J Sports Med"},{"issue":"3","key":"7239_CR15","doi-asserted-by":"publisher","first-page":"230949901879978","DOI":"10.1177\/2309499018799787","volume":"26","author":"R Ranjan","year":"2018","unstructured":"Ranjan R, Gaba S, Goel L, Asif N, Kalra M, Kumar R, et al. In vivo comparison of a fixed loop (EndoButton CL) with an adjustable loop (TightRope RT) device for femoral fixation of the graft in ACL reconstruction: a prospective randomized study and a literature review. J Orthop Surg (Hong Kong). 2018;26(3):2309499018799787. https:\/\/doi.org\/10.1177\/2309499018799787.","journal-title":"J Orthop Surg (Hong Kong)"},{"issue":"2","key":"7239_CR16","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1177\/0363546513507769","volume":"42","author":"AE Barrow","year":"2014","unstructured":"Barrow AE, Pilia M, Teja G, Kadrmas WR, Burns TC. Femoral suspension devices for anterior cruciate ligament reconstruction: do adjustable loops lengthen? Am J Sports Med. 2014;42(2):343\u20139. https:\/\/doi.org\/10.1177\/0363546513507769.","journal-title":"Am J Sports Med"}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-024-07239-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12891-024-07239-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-024-07239-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T13:06:14Z","timestamp":1707138374000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-024-07239-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,5]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["7239"],"URL":"https:\/\/doi.org\/10.1186\/s12891-024-07239-x","relation":{},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,5]]},"assertion":[{"value":"25 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Ethics Committee of the Chiba University hospital approved this study (IRB no M10609). All study methods were carried out according to the relevant guidelines and regulations. Informed consent was obtained from all patients and guardians of minor patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"113"}}