{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T02:00:55Z","timestamp":1780797655307,"version":"3.54.1"},"reference-count":74,"publisher":"National Athletic Trainers' Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Up to 36% of patients will develop osteoarthritis within a decade of anterior cruciate ligament reconstruction (ACLR), and postoperative changes in gait mechanics have been shown to be associated with radiographic and biochemical markers of cartilage degeneration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterize changes in limb-loading symmetry during walking gait from 6 to 12 months after ACLR in patients with extensor mechanism autografts using force-sensing insoles and to compare the change in limb-loading metrics between patients with bone-patellar tendon-bone (BPTB) and quadriceps tendon (QT) autografts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Orthopaedic rehabilitation clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients or Other Participants<\/jats:title>\n                    <jats:p>Twenty-seven participants (20 female; 13 BPTB, 14 QT; age = 21.4 \u00b1 6.1 years) who underwent unilateral, primary ACLR with a BPTB or QT autograft.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Gait assessment, the International Knee Documentation Committee (IKDC) survey, and the ACL-Return to Sport after Injury (ACL-RSI) survey were completed 6 \u00b1 1 and 12 \u00b1 2 months post-ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants experienced a significant increase in ACLR limb peak impact force (\n                      <jats:italic>P<\/jats:italic>\n                      = .007), average loading rate (\n                      <jats:italic>P<\/jats:italic>\n                      = .043), and instantaneous loading rate (\n                      <jats:italic>P<\/jats:italic>\n                      = .021) over time, but no significant changes were found in the contralateral limb or limb symmetry index (LSI). No differences were found in the change in LSI for any variable between graft cohorts. Participants experienced a significant improvement in the IKDC score, but the ACL-RSI score did not significantly improve.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>When tested in the clinical environment using force-sensing insoles, an increase in ACLR limb loading occurred from 6 to 12 months post-ACLR, but this change is not affected by autograft source.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-0245.25","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:52:00Z","timestamp":1770771120000},"page":"384-391","source":"Crossref","is-referenced-by-count":0,"title":["A Graft Source Comparison of Changes in Walking Gait After Anterior Cruciate Ligament Reconstruction Using Force-Sensing Insoles"],"prefix":"10.4085","volume":"61","author":[{"given":"Rachel E.","family":"Cherelstein","sequence":"first","affiliation":[{"name":"Inova Health System, Fairfax, VA"},{"name":"University of Miami Miller School of Medicine, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Kuenze","sequence":"additional","affiliation":[{"name":"Inova Health System, Fairfax, VA"},{"name":"University of Virginia Department of Kinesiology, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle C.","family":"Walaszek","sequence":"additional","affiliation":[{"name":"University of Virginia Department of Kinesiology, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily R.","family":"Brumfield","sequence":"additional","affiliation":[{"name":"Inova Health System, Fairfax, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer N.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Inova Health System, Fairfax, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Moler","sequence":"additional","affiliation":[{"name":"University of Virginia Department of Kinesiology, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Cross","sequence":"additional","affiliation":[{"name":"University of Virginia Department of Kinesiology, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward S.","family":"Chang","sequence":"additional","affiliation":[{"name":"Inova Health System, Fairfax, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"1","key":"i1938-162X-61-6-384-b01","series-title":"Br J Sports Med","first-page":"14","article-title":"Panther Symposium ACL Treatment Consensus Group. 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Progressive changes in walking kinematics and kinetics after anterior cruciate ligament injury and reconstruction: a review and meta-analysis. J Athl Train. 2017;52(9):847\u2013860. doi:10.4085\/1062-6050-52.6.06"},{"issue":"5","key":"i1938-162X-61-6-384-b05","series-title":"J Appl Biomech","first-page":"330","article-title":"Anterior cruciate ligament reconstruction does not fully restore normal 3D knee kinematics at 12 months during walking and walk-pivoting: a longitudinal gait analysis study","volume":"31","author":"Hasegawa","year":"2015","unstructured":"Hasegawa T,\nOtani T,\nTakeda K, et al. Anterior cruciate ligament reconstruction does not fully restore normal 3D knee kinematics at 12 months during walking and walk-pivoting: a longitudinal gait analysis study. 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Curr Rheumatol Rep. 2014;16(10):448. doi:10.1007\/s11926-014-0448-1"},{"issue":"1","key":"i1938-162X-61-6-384-b11","series-title":"Cartilage","article-title":"Loading during midstance of gait is associated with magnetic resonance imaging of cartilage composition following anterior cruciate ligament reconstruction","volume":"13","author":"Bjornsen","year":"2022","unstructured":"Bjornsen E,\nSchwartz TA,\nLisee C, et al. Loading during midstance of gait is associated with magnetic resonance imaging of cartilage composition following anterior cruciate ligament reconstruction. 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Gait mechanics and T1\u03c1 MRI of tibiofemoral cartilage 6 months after ACL reconstruction. Med Sci Sports Exerc. 2019;51(4):630\u2013639. doi:10.1249\/MSS.0000000000001834"},{"issue":"10","key":"i1938-162X-61-6-384-b14","series-title":"J Orthop Res","first-page":"2288","article-title":"Biochemical markers of cartilage metabolism are associated with walking biomechanics 6-months following anterior cruciate ligament reconstruction","volume":"35","author":"Pietrosimone","year":"2017","unstructured":"Pietrosimone B,\nLoeser RF,\nBlackburn JT, et al. Biochemical markers of cartilage metabolism are associated with walking biomechanics 6-months following anterior cruciate ligament reconstruction. J Orthop Res. 2017;35(10):2288\u20132297. doi:10.1002\/jor.23534"},{"issue":"7","key":"i1938-162X-61-6-384-b15","series-title":"Osteoarthritis Cartilage","first-page":"1006","article-title":"Synovial fluid concentrations of matrix metalloproteinase-3 and interluekin-6 following anterior cruciate ligament injury associate with gait biomechanics 6 months following reconstruction","volume":"29","author":"Evans-Pickett","year":"2021","unstructured":"Evans-Pickett A,\nLongobardi L,\nSpang JT, et al. Synovial fluid concentrations of matrix metalloproteinase-3 and interluekin-6 following anterior cruciate ligament injury associate with gait biomechanics 6 months following reconstruction. 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Clin Biomech (Bristol). 2023;104:105941. doi:10.1016\/j.clinbiomech.2023.105941"},{"key":"i1938-162X-61-6-384-b26","series-title":"J Biomech","first-page":"110989","article-title":"Aberrant gait biomechanics in individuals with ACL reconstruction are magnified during treadmill walking","volume":"134","author":"Dewig","year":"2022","unstructured":"Dewig DR,\nMills HR,\nEvans-Pickett A,\nPietrosimone BG,\nTroy Blackburn J. Aberrant gait biomechanics in individuals with ACL reconstruction are magnified during treadmill walking. J Biomech. 2022;134:110989. doi:10.1016\/j.jbiomech.2022.110989"},{"issue":"2","key":"i1938-162X-61-6-384-b27","series-title":"Sensors (Basel)","first-page":"265","article-title":"The reliability and validity of the loadsol\u00ae under various walking and running conditions","volume":"19","author":"Renner","year":"2019","unstructured":"Renner KE,\nWilliams DSB,\nQueen RM. 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Phys Ther Sport. 2008;9(1):9\u201315. doi:10.1016\/j.ptsp.2007.09.003"},{"issue":"7","key":"i1938-162X-61-6-384-b35","series-title":"Am J Sports Med","first-page":"1549","article-title":"Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery","volume":"41","author":"Ardern","year":"2013","unstructured":"Ardern CL,\nTaylor NF,\nFeller JA,\nWhitehead TS,\nWebster KE. Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery. Am J Sports Med. 2013;41(7):1549\u20131558. doi:10.1177\/0363546513489284"},{"issue":"5","key":"i1938-162X-61-6-384-b36","series-title":"Br J Sports Med","first-page":"377","article-title":"A prospective longitudinal study to assess psychological changes following anterior cruciate ligament reconstruction surgery","volume":"43","author":"Langford","year":"2009","unstructured":"Langford JL,\nWebster KE,\nFeller JA. A prospective longitudinal study to assess psychological changes following anterior cruciate ligament reconstruction surgery. Br J Sports Med. 2009;43(5):377\u2013381. doi:10.1136\/bjsm.2007.044818"},{"key":"i1938-162X-61-6-384-b37","series-title":"J Biomech","first-page":"94","article-title":"Real-time biofeedback can increase and decrease vertical ground reaction force, knee flexion excursion, and knee extension moment during walking in individuals with anterior cruciate ligament reconstruction","volume":"76","author":"Luc-Harkey","year":"2018","unstructured":"Luc-Harkey BA,\nFranz JR,\nBlackburn JT,\nPadua DA,\nHackney AC,\nPietrosimone B. Real-time biofeedback can increase and decrease vertical ground reaction force, knee flexion excursion, and knee extension moment during walking in individuals with anterior cruciate ligament reconstruction. J Biomech. 2018;76:94\u2013102. doi:10.1016\/j.jbiomech.2018.05.043"},{"issue":"1","key":"i1938-162X-61-6-384-b01","series-title":"Br J Sports Med","first-page":"14","article-title":"Panther Symposium ACL Treatment Consensus Group. Treatment after ACL injury: Panther Symposium ACL Treatment Consensus Group","volume":"55","author":"Diermeier","year":"2021","unstructured":"Diermeier TA,\nRothrauff BB,\nEngebretsen L, et al.; Panther Symposium ACL Treatment Consensus Group. Treatment after ACL injury: Panther Symposium ACL Treatment Consensus Group. Br J Sports Med. 2021;55(1):14\u201322. doi:10.1136\/bjsports-2020-102200"},{"issue":"10","key":"i1938-162X-61-6-384-b02","series-title":"Br J Sports Med","first-page":"597","article-title":"Knee kinematics and joint moments during gait following anterior cruciate ligament reconstruction: a systematic review and meta-analysis","volume":"50","author":"Hart","year":"2016","unstructured":"Hart HF,\nCulvenor AG,\nCollins NJ, et al. Knee kinematics and joint moments during gait following anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Br J Sports Med. 2016;50(10):597\u2013612. doi:10.1136\/bjsports-2015-094797"},{"issue":"12","key":"i1938-162X-61-6-384-b03","series-title":"Sports Med","first-page":"1869","article-title":"Movement patterns of the knee during gait following ACL reconstruction: a systematic review and meta-analysis","volume":"46","author":"Kaur","year":"2016","unstructured":"Kaur M,\nRibeiro DC,\nTheis JC,\nWebster KE,\nSole G. Movement patterns of the knee during gait following ACL reconstruction: a systematic review and meta-analysis. 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J Athl Train. 2017;52(9):847\u2013860. doi:10.4085\/1062-6050-52.6.06"},{"issue":"5","key":"i1938-162X-61-6-384-b05","series-title":"J Appl Biomech","first-page":"330","article-title":"Anterior cruciate ligament reconstruction does not fully restore normal 3D knee kinematics at 12 months during walking and walk-pivoting: a longitudinal gait analysis study","volume":"31","author":"Hasegawa","year":"2015","unstructured":"Hasegawa T,\nOtani T,\nTakeda K, et al. Anterior cruciate ligament reconstruction does not fully restore normal 3D knee kinematics at 12 months during walking and walk-pivoting: a longitudinal gait analysis study. J Appl Biomech. 2015;31(5):330\u2013339. doi:10.1123\/jab.2014-0175"},{"issue":"2","key":"i1938-162X-61-6-384-b06","series-title":"J Athl Train","first-page":"92","article-title":"Early gait biomechanics linked to daily steps after anterior cruciate ligament reconstruction","volume":"60","author":"B\u00fcttner","year":"2025","unstructured":"B\u00fcttner C,\nLisee C,\nBuck A, et al. Early gait biomechanics linked to daily steps after anterior cruciate ligament reconstruction. J Athl Train. 2025;60(2):92\u2013102. doi:10.4085\/1062-6050-0464.23"},{"issue":"10","key":"i1938-162X-61-6-384-b07","series-title":"J Biomech","first-page":"1948","article-title":"Quadriceps strength and weight acceptance strategies continue to improve two years after anterior cruciate ligament reconstruction","volume":"44","author":"Roewer","year":"2011","unstructured":"Roewer BD,\nDi Stasi SL,\nSnyder-Mackler L. Quadriceps strength and weight acceptance strategies continue to improve two years after anterior cruciate ligament reconstruction. J Biomech. 2011;44(10):1948\u20131953. doi:10.1016\/j.jbiomech.2011.04.037"},{"issue":"5","key":"i1938-162X-61-6-384-b08","series-title":"J Orthop Res","first-page":"1478","article-title":"Longitudinal changes in knee gait mechanics between 2 and 8 years after anterior cruciate ligament reconstruction","volume":"36","author":"Erhart-Hledik","year":"2018","unstructured":"Erhart-Hledik JC,\nChu CR,\nAsay JL,\nAndriacchi TP. Longitudinal changes in knee gait mechanics between 2 and 8 years after anterior cruciate ligament reconstruction. J Orthop Res. 2018;36(5):1478\u20131486. doi:10.1002\/jor.23770"},{"issue":"6","key":"i1938-162X-61-6-384-b09","series-title":"J Athl Train","first-page":"806","article-title":"Osteoarthritis prevalence following anterior cruciate ligament reconstruction: a systematic review and numbers-needed-to-treat analysis","volume":"49","author":"Luc","year":"2014","unstructured":"Luc B,\nGribble PA,\nPietrosimone BG. Osteoarthritis prevalence following anterior cruciate ligament reconstruction: a systematic review and numbers-needed-to-treat analysis. J Athl Train. 2014;49(6):806\u2013819. doi:10.4085\/1062-6050-49.3.35"},{"issue":"10","key":"i1938-162X-61-6-384-b10","series-title":"Curr Rheumatol Rep","first-page":"448","article-title":"Mechanisms of post-traumatic osteoarthritis after ACL injury","volume":"16","author":"Dare","year":"2014","unstructured":"Dare D,\nRodeo S. Mechanisms of post-traumatic osteoarthritis after ACL injury. 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J Orthop Res. 2017;35(10):2288\u20132297. doi:10.1002\/jor.23534"},{"issue":"7","key":"i1938-162X-61-6-384-b15","series-title":"Osteoarthritis Cartilage","first-page":"1006","article-title":"Synovial fluid concentrations of matrix metalloproteinase-3 and interluekin-6 following anterior cruciate ligament injury associate with gait biomechanics 6 months following reconstruction","volume":"29","author":"Evans-Pickett","year":"2021","unstructured":"Evans-Pickett A,\nLongobardi L,\nSpang JT, et al. Synovial fluid concentrations of matrix metalloproteinase-3 and interluekin-6 following anterior cruciate ligament injury associate with gait biomechanics 6 months following reconstruction. Osteoarthritis Cartilage. 2021;29(7):1006\u20131019. doi:10.1016\/j.joca.2021.03.014"},{"issue":"10","key":"i1938-162X-61-6-384-b16","series-title":"Med Sci Sports Exerc","first-page":"1771","article-title":"Worse tibiofemoral cartilage composition is associated with insufficient gait kinetics after ACL reconstruction","volume":"54","author":"Evans-Pickett","year":"2022","unstructured":"Evans-Pickett A,\nLisee C,\nHorton WZ, et al. Worse tibiofemoral cartilage composition is associated with insufficient gait kinetics after ACL reconstruction. Med Sci Sports Exerc. 2022;54(10):1771\u20131781. doi:10.1249\/MSS.0000000000002969"},{"issue":"4","key":"i1938-162X-61-6-384-b17","series-title":"Med Sci Sports Exerc","first-page":"785","article-title":"Bilateral gait 6 and 12 months post-anterior cruciate ligament reconstruction compared with controls","volume":"52","author":"Davis-Wilson","year":"2020","unstructured":"Davis-Wilson HC,\nPfeiffer SJ,\nJohnston CD, et al. 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Am J Sports Med. 2005;33(2):247\u2013254. doi:10.1177\/0363546504266483"},{"issue":"8","key":"i1938-162X-61-6-384-b19","series-title":"Scand J Med Sci Sports","first-page":"1212","article-title":"Patellar and hamstring autografts are associated with different jump task loading asymmetries after ACL reconstruction","volume":"29","author":"Miles","year":"2019","unstructured":"Miles JJ,\nKing E,\nFalvey \u00c9C,\nDaniels KAJ. Patellar and hamstring autografts are associated with different jump task loading asymmetries after ACL reconstruction. Scand J Med Sci Sports. 2019;29(8):1212\u20131222. doi:10.1111\/sms.13441"},{"issue":"8","key":"i1938-162X-61-6-384-b20","series-title":"Scand J Med Sci Sports","first-page":"1236","article-title":"Biomechanical asymmetries differ between autograft types during unplanned change of direction after ACL reconstruction","volume":"32","author":"Miles","year":"2022","unstructured":"Miles JJ,\nMcGuigan PM,\nKing E,\nDaniels KAJ. Biomechanical asymmetries differ between autograft types during unplanned change of direction after ACL reconstruction. Scand J Med Sci Sports. 2022;32(8):1236\u20131248. doi:10.1111\/sms.14166"},{"issue":"11","key":"i1938-162X-61-6-384-b21","series-title":"Knee Surg Sports Traumatol Arthrosc","first-page":"3871","article-title":"ACL Study Group. ACL Study Group survey reveals the evolution of anterior cruciate ligament reconstruction graft choice over the past three decades","volume":"29","author":"Arnold","year":"2021","unstructured":"Arnold MP,\nCalcei JG,\nVogel N, et al.; ACL Study Group. ACL Study Group survey reveals the evolution of anterior cruciate ligament reconstruction graft choice over the past three decades. 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Clin Biomech (Bristol). 2020;76:105014. doi:10.1016\/j.clinbiomech.2020.105014"},{"key":"i1938-162X-61-6-384-b25","series-title":"Clin Biomech (Bristol)","first-page":"105941","article-title":"Using load sensing insoles to identify knee kinetic asymmetries during landing in patients with an anterior cruciate ligament reconstruction","volume":"104","author":"Marrs","year":"2023","unstructured":"Marrs RP,\nCovell HS,\nPeebles AT,\nFord KR,\nHart JM,\nQueen RM. Using load sensing insoles to identify knee kinetic asymmetries during landing in patients with an anterior cruciate ligament reconstruction. Clin Biomech (Bristol). 2023;104:105941. doi:10.1016\/j.clinbiomech.2023.105941"},{"key":"i1938-162X-61-6-384-b26","series-title":"J Biomech","first-page":"110989","article-title":"Aberrant gait biomechanics in individuals with ACL reconstruction are magnified during treadmill walking","volume":"134","author":"Dewig","year":"2022","unstructured":"Dewig DR,\nMills HR,\nEvans-Pickett A,\nPietrosimone BG,\nTroy Blackburn J. Aberrant gait biomechanics in individuals with ACL reconstruction are magnified during treadmill walking. J Biomech. 2022;134:110989. doi:10.1016\/j.jbiomech.2022.110989"},{"issue":"2","key":"i1938-162X-61-6-384-b27","series-title":"Sensors (Basel)","first-page":"265","article-title":"The reliability and validity of the loadsol\u00ae under various walking and running conditions","volume":"19","author":"Renner","year":"2019","unstructured":"Renner KE,\nWilliams DSB,\nQueen RM. 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Sensors (Basel). 2018;18(12):4082. doi:10.3390\/s18124082"},{"issue":"10","key":"i1938-162X-61-6-384-b30","series-title":"J Orthop Sports Phys Ther","first-page":"685","article-title":"A comparison of negative joint work and vertical ground reaction force loading rates in Chi runners and rearfoot-striking runners","volume":"43","author":"Goss","year":"2013","unstructured":"Goss DL,\nGross MT. A comparison of negative joint work and vertical ground reaction force loading rates in Chi runners and rearfoot-striking runners. J Orthop Sports Phys Ther. 2013;43(10):685\u2013692. doi:10.2519\/jospt.2013.4542"},{"issue":"6","key":"i1938-162X-61-6-384-b31","series-title":"Clin Biomech (Bristol)","first-page":"697","article-title":"Are knee mechanics during early stance related to tibial stress fracture in runners","volume":"22","author":"Milner","year":"2007","unstructured":"Milner CE,\nHamill J,\nDavis I. Are knee mechanics during early stance related to tibial stress fracture in runners? 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Phys Ther Sport. 2008;9(1):9\u201315. doi:10.1016\/j.ptsp.2007.09.003"},{"issue":"7","key":"i1938-162X-61-6-384-b35","series-title":"Am J Sports Med","first-page":"1549","article-title":"Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery","volume":"41","author":"Ardern","year":"2013","unstructured":"Ardern CL,\nTaylor NF,\nFeller JA,\nWhitehead TS,\nWebster KE. Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery. Am J Sports Med. 2013;41(7):1549\u20131558. doi:10.1177\/0363546513489284"},{"issue":"5","key":"i1938-162X-61-6-384-b36","series-title":"Br J Sports Med","first-page":"377","article-title":"A prospective longitudinal study to assess psychological changes following anterior cruciate ligament reconstruction surgery","volume":"43","author":"Langford","year":"2009","unstructured":"Langford JL,\nWebster KE,\nFeller JA. 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