scholarly journals Femur originated genu varum in a patient with symptomatic ACL deficiency: a case report and review of literature

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Seyed Mohammad Javad Mortazavi ◽  
Abbas Noori ◽  
Farzad Vosoughi ◽  
Reza Rezaei Dogahe ◽  
Mohammad Javad Shariyate
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Corrective Osteotomy ◽  
Varus Deformity ◽  
Genu Varum ◽  
Level Of Evidence ◽  
Case Presentation ◽  
Acl Deficiency ◽  
Anterior Cruciate ◽  
Work Up

Abstract Background Anterior cruciate ligament (ACL) injury may be associated with genu varum. There are a few indications in which the varus deformity can be corrected at the time of ACL reconstruction. However, as the genu varum originates mostly from the tibia and the simultaneous presence of ACL deficiency and femur originated genu varum is uncommon, only a few papers have described their management for ACL deficient patients with femur originated genu varum. Case presentation A young patient visited our clinic with a complaint of right knee pain and giving way. Further work up revealed a full mid substance ACL tear, mild medial knee osteoarthritis and femur originated genu varum of his right knee. He was managed with simultaneous ACL reconstruction and distal femoral valgus osteotomy. Conclusions Any corrective osteotomy for genu varum should be performed at center of rotation angle. Isolated ACL reconstruction in patients with simultaneous ACL deficiency and genu varum may hasten the knee degeneration. Level of evidence IV

scholarly journals Combined Intra- and Extra-Articular Technique in Revision Anterior Cruciate Ligament Reconstruction

Joints ◽  
2017 ◽  
Vol 05 (03) ◽  
pp. 156-163 ◽  
Author(s):  
Jessica Zanovello ◽  
Federica Rosso ◽  
Alessandro Bistolfi ◽  
Roberto Rossi ◽  
Filippo Castoldi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Case Series ◽  
Return To Sport ◽  
Surgical Removal ◽  
Level Of Evidence ◽  
Anterior Cruciate ◽  
Over The Top

Purpose The aim of the study was to evaluate the “over the top” (OTT) nonanatomical technique for revision of anterior cruciate ligament (ACL) reconstruction. Methods Twenty-four patients with a mean age of 31.9 ± 11.2 years underwent revision of ACL reconstruction using OTT technique. International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, Tegner score, Subjective Patient Outcome for Return to Sport (SPORTS) score, Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) scale, and KT-1000 evaluation were recorded at a mean follow-up of 30.7 ± 18.9 months. Results Postoperatively, the IKDC objective total score significantly improved (p = 0.0046). The KOOS, Lysholm, and Tegner scores also improved, but the results were not statistically significant (62.4 vs. 72.6, 6.5 vs. 75.8, and 4.1 vs. 6.0, respectively). The subjective IKDC evaluation score improved from an average of 51.1 points to 63.7 points at the last follow-up (p = 0.0027). The RTP prevalence was 81.8%, with 44.4% of the patients returning to the same preinjury level. According to the SPORTS score, 16.6% of patients played sport without limitations in activity and performance. The average ACL-RSI score was 52.1 ± 27.0. No major complications were reported. A total of 21.5% of patients underwent surgical removal of staples. The failure prevalence was 14.3% and the cumulative survivorship, calculated using the Kaplan–Meier method, was equal to 70% at 60 months of follow-up. Conclusion The OTT technique in the revision ACL reconstruction provided improvement in objective and subjective scores, good RTP prevalence, and acceptable rate of complication and failure. One of the advantages was the possibility to avoid the femoral tunnel. Level of Evidence Level IV, therapeutic case series.

Use Caution When Assessing Preoperative Leg-Length Discrepancy in Pediatric Patients With Anterior Cruciate Ligament Injuries

2020 ◽  
Vol 48 (12) ◽  
pp. 2948-2953
Author(s):  
Madison R. Heath ◽  
Alexandra H. Aitchison ◽  
Lindsay M. Schlichte ◽  
Christine Goodbody ◽  
Frank A. Cordasco ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Intraclass Correlation ◽  
Case Series ◽  
Surgical Reconstruction ◽  
Radiographic Examination ◽  
Leg Length ◽  
Level Of Evidence ◽  
Anterior Cruciate

Background: Pre- and postoperative standing hip-to-ankle radiographs are critical for monitoring potential postoperative growth arrest and resultant deformities after pediatric anterior cruciate ligament (ACL) reconstruction. Purpose: To determine the prevalence of apparent preoperative leg-length discrepancies (LLDs) that resolve at the first postoperative radiographic examination in patients undergoing ACL reconstruction in order to understand what proportion of the noted preoperative deformities may have been inaccurate. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of prospectively collected preoperative and first postoperative full-length hip-to-ankle radiographs was performed in a cohort of skeletally immature patients who had an acute ACL injury and underwent subsequent surgical reconstruction. Leg length measurements for both the injured and the uninjured legs were obtained for comparison. Results: A total of 112 patients (mean age, 12.7 ± 1.7 years) were included (79 boys and 33 girls). Leg-length measurement interrater reliability among 3 raters for 25 randomly chosen images was nearly perfect (intraclass correlation coefficient, 0.996; 95% CI, 0.994-0.998). At baseline, there was no apparent preoperative LLD (<5 mm) in 48% (n = 54) of participants, while 37% (n = 41) displayed a small apparent LLD (5 to <10 mm), 12% (n = 13) displayed a moderate apparent LLD (10 to <15 mm), and 4% (n = 4) displayed a large apparent LLD (≥15 mm). Of the patients with an apparent preoperative LLD, 66% (n = 38) of them tore their ACL on the leg measuring shorter. At first postoperative radiographs, 48% (n = 28) of patients with an apparent preoperative LLD showed resolution to no LLD: 46% (n = 19) of patients with a small apparent preoperative LLD, 54% (n = 7) of patients with a moderate apparent LLD, and 50% (n = 2) of patients with a large apparent LLD. Conclusion: A high percentage of patients (48%) with apparent preoperative LLDs showed resolution to no LLDs by their first postoperative imaging, indicating that preoperative hip-to-ankle radiographs display some false LLDs in patients with recent ACL tears who are unable to fully extend their injured leg and bear weight.

scholarly journals Effects of Remnant Tissue Preservation on Tunnel Enlargement After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using the Hamstring Tendon

2018 ◽  
Vol 6 (12) ◽  
pp. 232596711881129 ◽  
Author(s):  
Tetsuro Masuda ◽  
Eiji Kondo ◽  
Jun Onodera ◽  
Nobuto Kitamura ◽  
Masayuki Inoue ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Double Bundle ◽  
Tissue Preservation ◽  
Tunnel Enlargement ◽  
Level Of Evidence ◽  
Anterior Cruciate ◽  
Double Bundle Acl Reconstruction ◽  
Tunnel Positions

Background: The effects of remnant tissue preservation on tunnel enlargement after anatomic double-bundle anterior cruciate ligament (ACL) reconstruction have not yet been established. Hypothesis: The preservation of ACL remnant tissue may significantly reduce the degree and incidence of tunnel enlargement after anatomic double-bundle ACL reconstruction, while the remnant-preserving procedure may not significantly increase the incidence of tunnel coalition after surgery. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 79 patients underwent anatomic double-bundle ACL reconstruction. Based on the Crain classification of ACL remnant tissue, 40 patients underwent the remnant-preserving procedure (group P), and the remaining 39 patients underwent the remnant-resecting procedure (group R). There were no differences between the 2 groups concerning all background factors, including preoperative knee instability and intraoperative tunnel positions. All patients were examined using computed tomography and a standard physical examination at 2 weeks and 1 year after surgery. Results: During surgery, the femoral and tibial anteromedial (AM) tunnel sizes in both groups averaged 6.6 and 6.5 mm, respectively. The femoral and tibial posterolateral (PL) tunnel sizes in both groups averaged 6 and 6 mm, respectively. There were no differences in the intraoperative tunnel positions and tunnel sizes between groups. Concerning the femoral AM tunnel, the degree of tunnel enlargement in the oblique coronal and oblique axial views in group P was significantly less than that in group R ( P = .0068 and .0323, respectively). Regarding the femoral AM tunnel cross-sectional area, the degree and incidence of tunnel enlargement in group P were significantly less than those in group R ( P = .0086 and .0278, respectively). There were no significant differences in tunnel coalition between groups. In each group, there were no significant relationships between tunnel enlargement and each clinical outcome. Conclusion: Remnant preservation in anatomic double-bundle ACL reconstruction reduced enlargement of the femoral AM tunnel and did not increase the incidence of tunnel coalition. This is one of the advantages of remnant-preserving ACL reconstruction.

Equivalent Knee Injury and Osteoarthritis Outcome Scores 12 and 24 Months After Anterior Cruciate Ligament Reconstruction: Results From the Swedish National Knee Ligament Register

2017 ◽  
Vol 45 (9) ◽  
pp. 2085-2091 ◽  
Author(s):  
Kristian Samuelsson ◽  
Robert A. Magnussen ◽  
Eduard Alentorn-Geli ◽  
Ferid Krupic ◽  
Kurt P. Spindler ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cohort Study ◽  
Acl Reconstruction ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Mean Difference ◽  
Level Of Evidence ◽  
Knee Ligament ◽  
Anterior Cruciate

Background: It is not clear whether Knee injury and Osteoarthritis Outcome Score (KOOS) results will be different 1 or 2 years after anterior cruciate ligament (ACL) reconstruction. Purpose: To investigate within individual patients enrolled in the Swedish National Knee Ligament Register whether there is equivalence between KOOS at 1 and 2 years after primary ACL reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: This cohort study was based on data from the Swedish National Knee Ligament Register during the period January 1, 2005, through December 31, 2013. The longitudinal KOOS values for each individual at the 1- and 2-year follow-up evaluations were assessed through the two one-sided test (TOST) procedure with an acceptance criterion of 4. Subset analysis was performed with patients classified by sex, age, graft type, and type of injury (meniscal and/or cartilage injury). Results: A total of 23,952 patients were eligible for analysis after exclusion criteria were applied (10,116 women, 42.2%; 13,836 men, 57.8%). The largest age group was between 16 and 20 years of age (n = 6599; 27.6%). The most common ACL graft was hamstring tendon (n = 22,504; 94.0%), of which the combination of semitendinosus and gracilis was the most common. A total of 7119 patients reported on the KOOS Pain domain at both 1- and 2-year follow-ups, with a mean difference of 0.21 (13.1 SD, 0.16 SE [90% CI, −0.05 to 0.46], P < .001). The same results were found for the other KOOS subscales: symptoms (mean difference −0.54, 14.1 SD, 0.17 SE [90% CI, −0.81 to −0.26], P < .001), activities of daily living (mean difference 0.45, 10.8 SD, 0.13 SE [90% CI, 0.24 to 0.66], P < .001), sports and recreation (mean difference −0.35, 22.7 SD, 0.27 SE [90% CI, −0.79 to 0.09], P < .001), quality of life (mean difference −0.92, 20.0 SD, 0.24 SE [90% CI, −1.31 to −0.53], P < .001), and the combined KOOS-4 score (mean difference −0.41, 14.5 SD, 0.17 SE [90% CI, −0.70 to −0.13], P < .001). Analyses within specific subsets of patients showed equivalent results between the 2 follow-up evaluations. Conclusion: Equivalent results within patients were found in KOOS values at 1- and 2-year follow-ups after ACL reconstruction. The finding was consistent across all KOOS subscales and for all evaluated subsets of patients. This result implies that there is no additional value in capturing both 1- and 2-year KOOS outcomes after ACL reconstruction. However, these findings of equivalence at 1- and 2-year endpoints do not alleviate the need for longer follow-up periods.

scholarly journals Return to Play and Performance in the Women’s National Basketball Association After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 8 (9) ◽  
pp. 232596712094707 ◽  
Author(s):  
Joseph S. Tramer ◽  
Lafi S. Khalil ◽  
Alexander Ziedas ◽  
Nima Mehran ◽  
Kelechi R. Okoroha
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
National Basketball Association ◽  
Return To Play ◽  
Level Of Evidence ◽  
Women's National Basketball Association ◽  
Playing Time ◽  
Anterior Cruciate ◽  
And Performance

Background: The incidence of anterior cruciate ligament (ACL) injuries in Women’s National Basketball Association (WNBA) athletes continues to increase. There is a paucity of data regarding return-to-play (RTP) rates and performance after ACL reconstruction in these athletes. Purpose: To quantify RTP rates and performance after ACL reconstruction in WNBA athletes. Study Design: Cohort study; Level of evidence, 3. Methods: All ACL tears sustained in the WNBA from 1997 through 2018 were identified. Body mass index (BMI), age, and position at the time of injury were collected for each player. RTP rates were calculated, and performance data were collected for each player before and after injury to determine changes in playing time and statistical performance. Players who successfully returned to play after ACL reconstruction were compared with a group of healthy controls who were matched by age, years of experience, position, height, and BMI. Statistics at 1 and 3 years after injury were compared to assess acute and longitudinal changes in performance relative to preinjury baseline. Results: A total of 59 WNBA players sustained ACL tears during the study period, and 41 (69.5%) were able to successfully RTP. Players played a mean of 7.5 ± 12.8 fewer games, played 5.0 ± 9.2 fewer minutes per game, and scored 3.7 ± 5.0 fewer points per game in their first year after RTP compared with the year before injury. Athletes with ACL reconstruction demonstrated significantly decreased performance measures regarding games played, games started, minutes, rebounds, assists, and blocks per game in their first season after RTP compared with control athletes in the same indexed year; however, these differences resolved by year 3 after surgery. Conclusion: WNBA athletes have a high RTP rate after ACL reconstruction. Players may experience an initial decrease in playing time and performance when returning to play; however, these variables were found to return to baseline over time.

Unicompartmental Knee Replacement Combined to Anterior Cruciate Ligament Reconstruction: Midterm Results

2019 ◽  
Vol 33 (11) ◽  
pp. 1152-1156
Author(s):  
Alberto Ventura ◽  
Claudio Legnani ◽  
Clara Terzaghi ◽  
Vittorio Macchi ◽  
Enrico Borgo
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Osteoarthritis ◽  
Acl Reconstruction ◽  
Knee Replacement ◽  
Cruciate Ligament ◽  
Unicompartmental Knee Replacement ◽  
Acl Deficiency ◽  
Womac Index ◽  
Unicompartmental Knee ◽  
Anterior Cruciate

AbstractA study was conducted to retrospectively evaluate the outcomes of combined medial unicompartmental knee replacement (UKR) and anterior cruciate ligament (ACL) reconstruction. The hypothesis was that this procedure would lead to satisfying results in patients affected by medial osteoarthritis and ACL insufficiency. Fourteen patients with ACL deficiency and concomitant medial compartment symptomatic osteoarthritis were treated from 2006 to 2010. Twelve of them were followed-up for an average time of 7.8 year (range: 6–10 years). Assessment included Knee Osteoarthritis Outcome score (KOOS), Oxford Knee score (OKS), American Knee Society scores (AKSS), Western Ontario and McMaster (WOMAC) index of osteoarthritis, Tegner's activity level, objective examination including instrumented laxity test with KT-1000 arthrometer, and standard X-rays. KOOS score, OKS, WOMAC index, and the AKSS improved significantly at follow-up (p < 0.001). There was no clinical evidence of instability in any of the knees as evaluated with clinical and instrumented laxity testing (p < 0.001). No pathologic radiolucent lines were observed around the components. In one patient, a total knee prosthesis was implanted due to the progression of signs of osteoarthritis in the lateral compartment 3 years after primary surgery. UKR combined with ACL reconstruction is an effective therapeutic option for the treatment of combined medial unicompartmental knee osteoarthritis and ACL deficiency and confirms subjective and objective clinical improvement up to 8 years after surgery. This study reflects level IV evidence.

Different Strategies in Making Transseptal Portal for the Different Purposes

2019 ◽  
Vol 33 (08) ◽  
pp. 825-831
Author(s):  
Yong Seuk Lee ◽  
Tae Woo Kim ◽  
Eui Soo Lee ◽  
Kyoung Hwan Lee ◽  
Seung Hoon Lee
Keyword(s):  
Acl Reconstruction ◽  
Anterior Part ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Matched Pair ◽  
Pcl Reconstruction ◽  
Level Of Evidence ◽  
Anatomical Structures ◽  
Tibial Footprint ◽  
Anterior Cruciate

AbstractThe purpose of this study was to find the most suitable and safe position of the transseptal portal in anatomic anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstructions. The hypothesis of this study was that area and position of the transseptal portal are different between ACL and PCL reconstructions for the observation of native footprint. A matched-pair comparison study was conducted on the arthroscopic images of 100 consecutive patients who underwent ACL reconstruction and 50 consecutive patients who underwent PCL reconstruction. The transseptum was divided into six compartments. The opened compartments for each surgery were then evaluated to find which anatomical structures are well seen. The anterior middle and upper parts were necessary for the ACL reconstruction, whereas middle and lower portions of the anterior and posterior compartments were necessary for the PCL reconstruction. A larger opening was necessary for PCL reconstruction than that for ACL reconstruction. The ACL posterior one-third, ACL femoral attachment, and apex of the deep cartilage margin (DCM) were viewed in 100% of the patients during ACL reconstruction. The PCL posterior one-third, PCL tibial attachment, PCL fovea margin, and medial meniscus around posterior margin were always viewed during PCL reconstruction. The anterior part of the septum, from the middle to the upper portions of the transseptum, was necessary to be opened for visualization of the femoral footprint and DCM of the lateral femoral condyle during ACL reconstruction. The anterior and posterior parts of the septum, from the middle to the lower portions of the transseptum, were necessary for excellent visualization of the PCL tibial footprint during PCL reconstruction. These paths of the transseptal portal for each surgery will help surgeons obtain both anatomic footprint restoration and maximal remnant preservation through the most suitable and safe means. This is a case–control study; level of evidence is 3.

scholarly journals Effect of leg dominance on early functional outcomes and return to sports after anterior cruciate ligament reconstruction

2020 ◽  
Vol 28 (1) ◽  
pp. 230949901989623
Author(s):  
HC Boo ◽  
TS Howe ◽  
Joyce SB Koh
Keyword(s):  
Acl Reconstruction ◽  
Functional Outcomes ◽  
Cruciate Ligament ◽  
Peak Torque ◽  
Return To Sports ◽  
Level Of Evidence ◽  
Limb Injuries ◽  
Outcome Scores ◽  
Anterior Cruciate ◽  
Leg Dominance

Introduction: The effect of leg dominance on anterior cruciate ligament (ACL) injuries has been studied with some studies noting a propensity for injuries in the non-dominant leg. Its effect on post-ACL reconstruction recovery, however, is not well known. The authors hypothesize that dominant limb injuries undergo rehabilitation faster and positively affect early functional outcome scores and return to sports and set about studying these effects. Methods: This is a retrospective study of 254 patients from a single institution who underwent ACL reconstruction for acute ACL ruptures and the results were compared between patients with dominant and non-dominant limb injuries. Objective measurements including the KT-1000, single-leg hop distance and Biodex knee extension peak torque were used to evaluate recovery. Pre- and post-operative functional outcome scores such as the International Knee Documentation Committee (IKDC), Tegner activity score and Lysholm knee scale were documented. Results: Early functional outcomes were similar. Minimal clinically important difference (MCID) improvement in IKDC scores was achieved in 69.7% of the dominant versus 66.0% of the non-dominant injury group ( p = 0.99), 75.2% versus 79.6% ( p = 0.45) for the Lysholm knee scale, and 81.6% versus 84.9% ( p = 0.50) for the Tegner activity score. The majority of patients in both subgroups had a return of at least 80% of peak knee flexion and extension peak torque at 5.4 months post-operatively; 92.9% of subjects with a non-dominant leg injury and 87.2% with a dominant leg injury had returned to their pre-injury sports 1 year from surgery. Conclusions: Results from this study suggest that despite theoretical differences, leg dominance does not have a significant impact on short-term functional outcomes and return to sports. Objective measurements suggest that limb strength recovers at a comparable rate. Injuries to either leg demonstrate equally positive improvement post-ACL reconstruction given the same post-operative rehabilitation. Level of Evidence: III, retrospective comparative study. Level of Evidence: III, retrospective cohort study.

scholarly journals Anterior Cruciate Ligament Reconstruction with LARS Artificial Ligament—Clinical Results after a Long-Term Follow-Up

Joints ◽  
2018 ◽  
Vol 06 (02) ◽  
pp. 075-079 ◽  
Author(s):  
Paolo Parchi ◽  
Gianluca Ciapini ◽  
Carlo Paglialunga ◽  
Michele Giuntoli ◽  
Carmine Picece ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Rating Scale ◽  
Cruciate Ligament ◽  
Case Series ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Anterior Cruciate

Purpose The aim of this retrospective study was to evaluate the subjective and functional outcome of anterior cruciate ligament (ACL) reconstruction with the synthetic Ligament Advanced Reinforcement System (LARS) ligament. Methods Twenty-six patients were reviewed at an average follow-up of 11.6 years. Objective clinical evaluation was performed with stability tests. Patient-reported outcomes (Visual Analogue Scale, Knee Injury and Osteoarthritis Outcome Score, and Cincinnati Knee Rating Scale) were used to assess subjective and functional outcomes. Results Overall satisfactory results were obtained in 22 cases (84.6%). Four patients (15.4%) showed mechanical failure of the graft. No cases of synovitis or infection were reported. Conclusion LARS ligament can be considered a safe and suitable option for ACL reconstruction in carefully selected cases, especially elderly patients needing a rapid postoperative recovery. Level of Evidence Level IV, retrospective case series.

scholarly journals The Top 100 Most Cited Articles on Anterior Cruciate Ligament Reconstruction: A Bibliometric Analysis

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712097637
Author(s):  
Ning Tang ◽  
Wenchao Zhang ◽  
Daniel M. George ◽  
Yang Su ◽  
Tianlong Huang
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Sports Medicine ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
The United States ◽  
Anatomic Reconstruction ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Anterior Cruciate

Background: The concept of anterior cruciate ligament (ACL) reconstruction (ACLR) has become widely accepted, gaining increased attention in recent years and resulting in many research achievements in this field. Purpose: The aim of this study was to determine which original articles on ACLR have been most influential in this field by identifying and analyzing the characteristics of the 100 most cited articles. Study Design: Cross-sectional study. Methods: Articles on ACLR were identified via the Thomson ISI Web of Science database on November 30, 2019. The 100 most cited articles were identified based on inclusion and exclusion criteria. The data extracted from each article for the subsequent analysis included title, date of publication, total citations, average citations per year (ACY), journal name, first author, institutions, themes, level of evidence, and keywords. Results: The total number of citations was 29,629. The date of publication ranged from 1975 to 2015. A majority of the articles originated from the United States (58%) and were published in the 1990s (32%) and 2000s (48%). The mean ACY was 18.43 ± 9.51. Of the selected articles, nearly one-half were published in the American Journal of Sports Medicine (42%). The most prolific co-author and first author were Freddie H. Fu (n = 13) and K. Donald Shelbourne (n = 5), respectively. The most productive institution was the University of Pittsburgh (14%). Material comparison (19%) and technique comparison (16%) were the 2 most popular themes. More than one-quarter of articles were level 4 evidence (37%). Moreover, the keywords ACL, ACL reconstruction, ACL rupture, knee joint, knee injuries, and human showed the highest degree of centrality. Conclusion: By analyzing the characteristics of articles, this study demonstrated that ACLR is a growing and popular area of research, with the focus of research varying through timeline trends. Studies on anatomic reconstruction and biomechanics might be areas of future trends.

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