***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: Objective To analyze the clinical outcomes of arthroscopic anterior cruciate ligament ( ACL ) reconstruction with irradiated bone-patellar tendon-bone ( BPTB ) allograft compared with non-irradiated allograft and autograft . Methods All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 mrad of irradiation prior to distribution . A total of 68 patients undergoing arthroscopic ACL reconstruction  were prospect ively r and omized consecutively into one of the two groups ( autograft and irradiated allograft groups ) . The same surgical technique was used in all operations done by the same senior surgeon . Before surgery and at the average of 31 months of follow-up ( ranging from 24 to 47 months ) , patients were evaluated by the same observer according to objective and subjective clinical evaluations . Results Of these patients , 65 ( autograft 33 , irradiated allograft 32 ) were available for full evaluation . When the irradiated allograft group was compared to the autograft group at the 31-month follow-up by the Lachman test , the anterior drawer test ( ADT ) , the pivot shift test , and KT-2000 arthrometer test , statistically significant differences were found . Most importantly , 87.8 % of patients in the autograft group and just only 31.3 % in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000 . The failure rate of the ACL reconstruction with irradiated allograft ( 34.4 % ) was higher than that with autograft ( 6.1 % ) . The anterior and rotational stabilities decreased significantly in the irradiated allograft group . According to the overall International Knee Documentation Committee ( IKDC ) , functional and subjective evaluations , and activity level testing , no statistically significant differences were found between the two groups . Besides , patients in the irradiated allograft group had a shorter operation time and a longer duration of postoperative fever . When the patients had a fever , the laboratory examinations of all patients were almost normal . Blood routine was normal , the values of erythrocyte sedimentation rate ( ESR ) were 5∼16 mm/h and the contents of C reactive protein ( CRP ) were 3∼10 mg/L. Conclusion We conclude that the short term clinical outcomes of the ACL reconstruction with irradiated BPTB allograft were adversely affected . The less than satisfactory results led the senior authors to discontinue the use of irradiated BPTB allograft in ACL surgery and not to advocate using the gamma irradiation as a secondary sterilizing method Delayed rather than early reconstruction of the anterior cruciate ligament is the current recommended treatment for injury to this ligament since it is thought to give a better functional outcome . We r and omised 105 consecutive patients with injury associated with chondral lesions no more severe than grade s 1 and 2 and /or meniscal tears which only required trimming , to early ( < two weeks ) or delayed ( > four to six weeks ) reconstruction of the anterior cruciate ligament using a quadrupled hamstring graft .  All operations were performed by a single surgeon and a st and ard rehabilitation regime was followed in both groups . The outcomes were assessed using the Lysholm score , the Tegner score and measurement of the range of movement . Stability was assessed by clinical tests and measurements taken with the KT-1000 arthrometer , with all testing performed by a blinded uninvolved experienced observer . A total of six patients were lost to follow-up , with 48 patients assigned to the delayed group and 51 to the early group . None was a competitive athlete . The mean interval between injury and the surgery was seven days ( 2 to 14 ) in the early group and 32 days ( 29 to 42 ) in the delayed group . The mean follow-up was 32 months ( 26 to 36 ) . The results did not show a statistically significant difference for the Lysholm score ( p = 0.86 ) , Tegner activity score ( p = 0.913 ) or the range of movement ( p = 1 ) . Similarly , no distinction could be made for stability testing by clinical examination ( p = 0.56 ) and measurements with the KT-1000 arthrometer ( p = 0.93 ) . Reconstruction of the anterior cruciate ligament gave a similar clinical and functional outcome whether performed early ( < two weeks ) or late at four to six weeks after injury The Losee repair controls rotational subluxation of the lateral femoral condyle , or pivot shift , but does not reliably eliminate Lachman laxity . Despite this surgical limitation , many patients who were operated on continued to do high-dem and activities at the last followup . We hypothesized that Lachman findings alone did not predict poor surgical outcome or progression to osteoarthritis . We report on 87 patients evaluated at an average of 9 years ( range , 5 - 21 years ) postoperatively . Prospect ively collected examinations and radiographic , subjective , and objective outcome measures were recorded and statistically evaluated . The presence of a postoperative pivot shift or residual varus laxity correlated with poor patient subjective evaluations and poor scoring outcomes . Lachman laxity with an absent pivot shift had no correlation with the outcome measures or onset of radiographic progression to osteoarthritis . Meniscectomy , additional knee surgery , increased valgus or varus laxity , and time from injury until the final radiograph positively correlated with the onset of osteoarthritis . Elimination of the pivot shift was necessary to achieve successful relief of symptoms and functional outcome . In the absence of a pivot shift , Lachman laxity was not solely predictive of poor outcomes . Level of Evidence : Prognostic study , Level II-1 ( retrospective study ) . See the Guidelines for Authors for a complete description of levels of evidence The purpose of this study is to clinical ly evaluate hamstring tendon anterior cruciate ligament (ACL)-reconstruction using femoral fixation with bioresorbable interference screws and with a bioresorbable transfixation device . The ACL-reconstruction using the transfixation device at the femoral side leads to less knee laxity and therefore to a better clinical outcome for the patient . Prospect i ve r and omized clinical outcome study . From February 2002 to December 2002 , a total of 68 patients with hamstring ACL reconstruction using a femoral fixation once with TransFix ( n=38 ; m:22 and f:16 ; median age=28.5 range 15–47 ) and the second with bioscrew ( BS ) ( n=30 ; m:20 , f:10 ; median age=25.5 range 13–61 ) completed the follow-up period . Patients in each group got a clinical assessment at 3 , 6 , and 12 months after surgery . The measurement of anterior translation of the tibia has been performed using the Rolimeter ® device . No significant differences in the knee laxity testing using the Rolimeter device were seen between both groups and over time within these groups . Ninety percent of all patients had functionally normal or near normal International Knee Documentation Committee ( IKDC ) knee ligament ratings . The TF-group included 17 grade A , 19 grade B , and 2 grade C knees , and the BS-group had 12 grade A , 13 grade B , and 5 grade C knees .  The IKDC rating , the OAK-score , the Tegner-activity-score , and the Lysholm-score did not show significant differences between the TF-group and the BS-group . We disproved our hypothesis that the transfixation technique leads to less laxity and therefore to a better clinical outcome when compared to the use of BS . The clinical results in this study clarified that this technique is an effective and safe method for femoral hamstring fixation in ACL-reconstruction . However , this technique revealed no advantage compared to the bioscrew fixation technique within the short-term follow-up BACKGROUND There are no controlled , prospect i ve studies comparing the 10-year outcomes of anterior cruciate ligament ( ACL ) reconstruction using patellar tendon ( PT ) and 4-str and hamstring tendon ( HT ) autografts . HYPOTHESIS Comparable results are possible with HT and PT autografts . STUDY DESIGN Cohort study ; Level of evidence , 2 . METHODS One hundred eighty ACL-deficient knees that met inclusion criteria underwent ACL reconstruction ( 90 HT autograft , 90 PT autograft ) by one surgeon and were treated with an accelerated rehabilitation program . All knees were observed in a prospect i ve fashion with subjective , objective , and radiographic evaluation at 2 , 5 , 7 , and 10-year intervals . RESULTS At 10 years , there were no differences in graft rupture rates ( 7/90 PT vs. 12/90 HT , P = .24 ) . There were 20 contralateral ACL ruptures in the PT group , compared with 9 in the HT group ( P = .02 ) . In all patients , graft rupture was associated with instrumented laxity > 2 mm at 2 years ( P = .001 ) . Normal or near-normal function of the knee was reported in 97 % of patients in both groups . In the PT group , harvest-site symptoms ( P = .001 ) and kneeling pain ( P = .01 ) were more common than in the HT group . More patients reported pain with strenuous activities in PT knees than in HT knees ( P = .05 ) . Radiographic osteoarthritis was more common in PT knees than the HT-reconstructed knees ( P = .04 ) . The difference , however , was composed of patients with mild osteoarthritis . Other predictors of radiographic osteoarthritis were < 90 % single-legged hop test at 1 year and the need for further knee surgery . An " ideal " outcome , defined as an overall International Knee Documentation Committee grade of A or B and a radiographic grade of A at 10 years after ACL reconstruction , was associated with <3 mm of instrumented laxity at 2 years , the absence of additional surgery in the knee , and HT grafts . CONCLUSIONS It is possible to obtain excellent results with both HT and PT autografts . We recommend HT reconstructions to our patients because of decreased harvest-site symptoms and radiographic osteoarthritis Introduction Correct placement of both tibial and femoral tunnels is one of the main factors for a favorable clinical outcome after anterior cruciate ligament ( ACL ) reconstruction . We used an original system of computer assisted surgery ( CAS ) . The system , based on fluoroscopic guidance combined with special graphical software of image analyzing , showed to the surgeon , before drilling , the recommended placement of tibial and femoral tunnel centers . We compared the first anatomical and clinical results of this procedure to the usual one single incision technique . Material s and methods We conducted a prospect i ve study on 73 patients ; 37 patients were operated on with CAS and 36 without CAS , by the same senior surgeon . The mean age was 27 years for both groups . Every patient was review ed at an average of 2.2 years ( range 1–4.5 ) by an independent observer , using IKDC scoring system , KT-1000 , and passive stress radiographs . Results Time between ACL rupture and reconstruction averaged 30 months for both groups . CAS needed 9.3 min extra surgery time . Clinical evaluation was grade d from A to C as per the IKDC scoring system : 67.6 % A , 29.7 % B , 2.7 % C with CAS ; and 60 % A , 37.1 % B , 2.9 % C without CAS . IKDC subjective knee evaluation score averaged 89.7 with CAS and 89.5 without CAS . Pre operative KT-1000 maxi manual differential laxity averaged 7 . At revision time , all the patients after CAS had a differential laxity less than 2 and 97.7 % without CAS . Stress X-rays differential laxity averaged 2.4 mm with CAS and 3 mm without CAS . The area of dispersion of the tunnels ’ center was smaller on the femoral side using the CAS method . There was no statistically significant difference between both groups using IKDC score , KT-1000 and passive stress radiographs . Conclusions The CAS method provided a more accurate and reproducible tunnels placement without clinical significant effect PURPOSE The aim of this study was to evaluate whether a change in the femoral graft insertion site between the 1-o'clock ( high ) and 2-o'clock ( low ) positions could change the laxity , the score on the 2000 International Knee Documentation Committee ( IKDC ) Knee Examination Form , or the score on the 2000 subjective IKDC Knee Evaluation Form in the anterior cruciate ligament (ACL)-reconstructed knee . METHODS The study was design ed as a prospect i ve , r and omized , double-blind investigation . We r and omized 30 patients to the low tunnel position group and 30 to the high tunnel position group . Four-str and ed semitendinosus and gracilis single-bundle grafts were used . At follow-up , the patients were examined according to the  IKDC evaluation form and the IKDC examination form . The exact measurements of laxity at 25 degrees and 70 degrees were performed by use of the Rolimeter ( Aircast , Boca Raton , FL ) . St and ardized radiographs were evaluated . RESULTS In total , 26 patients in the low tunnel position group and 25 in the high tunnel position group completed the study . At follow-up , we found no significant difference in the laxity at 25 degrees and 70 degrees or scores on 
    Output:
    
Conclusion The pivot shift test is an important test following ACL reconstruction , and it correlates with functional outcomes