***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background and purpose No prospect i ve surveillance systems have been available for monitoring the outcome of  cruciate ligament surgery in Sc and inavia ( Denmark , Norway , and Sweden ) . In the present paper we describe the Sc and inavian ACL registries including their main function , similarities , and preliminary baseline results . Methods The Sc and inavian registries were established in 2004 ( Norway ) and 2005 ( Denmark and Sweden ) . The Danish and Swedish registries were originally based on the Norwegian registry , and there is no overriding difference between the three . In Denmark , all hospitals and clinics are legally bound to report to an approved national data base . In Norway and Sweden , the registries are based on voluntarily reporting by surgeons . Results The annual incidence of primary ACL reconstructions  is higher in Denmark than in Norway , except in females younger than 20 years . Among Sc and inavian surgeons , there is a similar approach to the patients . Differences do , however , exist regarding choice of grafts , choice of implants , and choice of treatment of simultaneous meniscal and cartilage injuries ; the proportion of ACL reconstructions performed as outpatient surgery ; and the use of prophylactic anticoagulation . Clinical ly , the preoperative KOOS scores are not significantly different between the Sc and inavian registries , except that Denmark reports more symptoms both pre- and postoperatively . Interpretation The Sc and inavian national ACL registries will generate new data about ACL reconstructions . They will contribute important knowledge regarding ACL epidemiology . They will be the only source of data on the performance of a wide range of different implants and techniques . In addition , they will hopefully have an impact on the selection of methods for ACL reconstructions in Sc and inavia and elsewhere Background : Subsequent surgeries have a profound effect on patient satisfaction and outcome after  primary anterior cruciate ligament reconstruction ( ACLR ) .  There have been no prospect i ve studies to date describing the rate and predictors ( surgical and patient variables ) of all subsequent knee surgeries at short-term and midterm follow-up along with analyses of surgical and patient variables that are associated with subsequent surgeries . Purpose : To report the rate and predictors of all subsequent surgeries at short-term and midterm follow-up along with associated patient variables . Study Design : Case-control study ; Level of evidence , 3 . Methods : A total of 980 patients ( 540 male ) were prospect ively enrolled in a Multicenter Orthopaedic Outcomes Network ( MOON ) cohort from January 2002 to December 2003 . The 2- and 6-year follow-up information for subsequent procedures was obtained . Operative reports were obtained , and all procedures were categorized . Results : One hundred eighty-five patients underwent a subsequent surgery on the ipsilateral leg ( 18.9 % ) and 100 on the contralateral knee ( 10.2 % ) at 6-year follow-up . On the ipsilateral knee , there was a 7.7 % rate of ACL revisions , a 13.3 % rate of cartilage procedures , a 5.4 % rate of arthrofibrosis procedures , and a 2.4 % rate of procedures related to hardware . For the contralateral knee , there was a 6.4 % rate of primary ACL ruptures . Younger age at the index surgery and the use of allografts were predictors ( risk factors ) for subsequent surgery . Revision ACLR , female sex , body mass index , and surgical exposure were not significant predictors . Conclusion : At 6-year follow-up , 18.9 % of patients who had undergone ACLR  underwent subsequent surgeries on the ipsilateral knee . The rates between an ipsilateral ACLR graft versus a contralateral normal ACL tear were similar ( 7.7 % vs 6.4 % , respectively ) . Younger age and the use of allografts were risk factors for subsequent surgery Objective The aim of this work was to compare the prevalence of cyclops lesions  after anterior cruciate ligament reconstruction ( ACLR )  using the single-bundle and remnant bundle preservation techniques . Material s and methods One hundred consecutive patients , who had undergone postoperative MRI of the knee followed by arthroscopic ACLR with the remnant bundle preservation technique ( R ) between February 2007 and August 2010 , were enrolled in this study . Thirty-six consecutive patients who underwent ACLR using the single-bundle technique ( S ) were also included in this study as a control group . The MR findings were scored based on the presence of pre-ACL graft lesion as 0 , 1 , 2 , or 3 on the sagittal images . The sixty-one specimens by second-look surgery ( 20 in S , 41 in R ) were pathologically examined . Results The numbers of patients with scores of 0 , 1 , 2 , and 3 were 1 , 18 , 14 , and 3 in group S and 4 , 60 , 29 , and 7 , in group R , respectively . Of the 61 patients who underwent second-look surgery ( 20 in S , 41 in R ) , eight had a cyclops lesion ( three in group S and five in group R ) . The prevalence of cyclops lesion was not significantly different in group R and group S ( p = 0.761 ) . Conclusions The prevalence of a cyclops lesion was similar in both groups Background The purpose of this study was to assess the quality of methodology in orthopaedics-related r and omized controlled trials ( RCTs ) published from January 2006 to December 2010 in the top orthopaedic journals based on impact scores from the Thompson ISI citation reports ( 2010 ) . Methods Journals included American Journal of Sports Medicine ; Journal of Orthopaedic Research ; Journal of Bone and Joint Surgery , American ; Spine Journal ; and Osteoarthritis and Cartilage . Each RCT was assessed on ten criteria ( r and omization method , allocation sequence concealment , participant blinding , outcome assessor blinding , outcome measurement , interventionist training , withdrawals , intent to treat analyses , clustering , and baseline characteristics ) as having empirical evidence for biasing treatment effect estimates when not performed properly . Results A total of 232 RCTs met our inclusion criteria . The proportion of RCTs in published journals fell from 6 % in 2006 to 4 % in 2010 . Forty-nine percent of the criteria were fulfilled across these journals , with 42 % of the criteria not being amendable to assessment due to inadequate reporting . The results of our regression revealed that a more recent publication year was significantly associated with more fulfilled criteria ( β = 0.171 ; CI = −0.00 to 0.342 ; p = 0.051 ) . Conclusion In summary , very few studies met all ten criteria . Thus , many of these studies likely have biased estimates of treatment effects . In addition , these journals had poor reporting of important method ological aspects BACKGROUND Post-operative sensory disturbances following anterior cruciate ligament ( ACL ) reconstruction  using the quadruple hamstring tendon is a prevalent complication . This study evaluates the impact of exploration and salvage of superficial branches of the saphenous nerve on the incidence of post-operative sensory loss . METHODS In a prospect i ve descriptive study , 98 out of 120 patients with ACL reconstruction operated by the transfix method  were followed 2 weeks and 6 months post-surgery . Hamstring tendon autograft was harvested through a 2 - 3 cm anteromedial oblique incision just over the pes anserinus . Meticulous dissection was done to find and save the superficial sensory branches of the saphenous nerve through the incision . Sensory changes were evaluated by physical examination for light touch ; patients were requested to complete a specific diagram to evaluate sensory loss . RESULTS In 44 patients at least one nerve was located and saved . The rate of hypoesthesia in this group of patients was 20.5 % . In 54 patients we were unable to locate the nerve . The rate of hyposthesia in this group was 72 % , which was statistically significant ( P < 0.005 ) . The overall rate of sensory disturbance in 98 patients was 48.9 % . A total of 10 patients developed hyposthesia over the anteromedial part of the Mid-leg . CONCLUSION Exploration and salvage of the sensory branches of the saphenous nerve has a tremendous effect on the rate of sensory deficit Purpose To compare the incidence , extent of sensory loss , its clinical effect and natural course caused by three different skin incisions used for autogenous hamstring graft harvest during anterior cruciate ligament ( ACL ) reconstruction . Methods One hundred and twenty patients who underwent hamstring graft harvest during ACL reconstruction , participated in the study . All patients were r and omized into 3 groups as per the 3 incisions used — vertical , transverse and oblique . The area of sensory loss was documented as per anatomical distribution of the infrapatellar branch of saphenous nerve ( IPSBN ) and sartorial branch of sensory nerve ( SBSN ) at 6 weeks , 3 months and 6 months follow-ups . The length of incision , area of sensory loss and subjective pain score ( out of 10 ) were also noted . Results The incidence , area of hypesthesia and persistence at 6 months were significantly higher with vertical incision at all times , whereas it was the least with oblique incision . Injury to IPSBN was maximum with vertical incision ( p = 0.000 ) , and it was similar in the transverse and oblique incision groups . The SBSN injury incidence was not significantly different between the three groups ( n.s . ) . Subjective cutaneous hypesthesia incidence was quite low in all the three groups . The oblique incision group had highest subjective satisfaction closely followed by the horizontal incision group . Conclusions Vertical incision has highest incidence of IPBSN injury , persistent hypesthesia , largest area of sensory loss and poorest subjective outcome .  Oblique and transverse incision groups had statistically comparable results , though better outcome was noted in the oblique incision group . The SBSN injury was equally common in all the three incisions used . However , the sensory loss does not impair normal daily activities in the patients . We recommend use of oblique incision for hamstring graft harvest . Level of evidence Therapeutic r and omized controlled prospect i ve study , Level Purpose This study was undertaken to prospect ively analyse , at a mean five-year follow-up , the clinical , functional , and radiographic outcomes in patients who developed postoperative acute septic knee arthritis following anterior cruciate ligament ( ACL ) reconstruction using hamstring autograft .  We also assessed the effect of multiple arthroscopic debridement and graft retention on the functional outcomes in comparison with the matched control group . Methods From a consecutive case series of 2,560 ACL-injured patients who were treated with arthroscopic ACL reconstruction , we report on 24 cases with postoperative septic knee arthritis . These patients were individually matched for age , sex , comorbidity , body mass index ( BMI ) and preinjury Tegner activity scale in a ratio of 1/1 . Clinical , laboratory , synovial fluid analysis and culture were performed . Arthroscopic debridement and graft retention was done for all cases , in addition to antibiotic therapy IV . A detailed physical examination , KT1000 laxity testing , Lysholm knee score , Tegner activity level scale , International Knee Documentation Committee ( IKDC ) , and Knee Injury and Osteoarthritis Outcome Score ( KOOS ) were completed . Results In all cases , treatment of infection was successful after a median of three ( range one to six ) repeated arthroscopic graft debridement and retention , in addition to antibiotic therapy IV . At an average of five years follow-up , two patients had over five millimetres manual maximum side-to-side difference in laxity . There were no significant differences between groups regarding Lysholm score , IKDC and KOOS . Median final Tegner activity score was 5.5 versus 7 in the control group ( p = 0.004 ) . Complications included graft rupture in three patients , loss of range of motion in five , Sudeck ’s atrophy in one and moderate joint narrowing in two . There were no recurrences of septic arthritis or bone infection . Conclusion Graft retention seems not only possible but appropriate in view of the experience presented in this article for postoperative septic knee arthritis using hamstring autograft . A potential residual complication is arthrofibrosis , which deserves maximum attention Objective : To compare 3 anatomically positioned autografts for anterior cruciate ligament ( ACL ) reconstruction , by measuring patient-reported disease-specific quality of life at 2 years postoperatively . Design : Double-blinded , r and omized clinical trial with intraoperative computer-generated treatment allocation . Patients and an independent trained evaluator were blinded . Setting : University-based orthopedic referral practice . Patients : Three hundred thirty patients ( 14 - 50 years ; 183 male patients ) with isolated ACL deficiency were equally r and omized to : ( 1 ) patellar tendon , PT : 28.7 years ( SD = 9.7 ) ; ( 2 ) quadruple-str and ed hamstring tendon , HT : 28.5 years ( SD = 9.9 ) ; and ( 3 ) double bundle using HT , DB : 28.3 years ( SD = 9.8 ) ; 322 patients completed 2-year follow-up . Intervention : Anterior cruciate ligament reconstruction using PT , HT , or DB autografts . Main Outcome Measures : Measured at baseline , 1 and 2 years postoperatively— primary : anterior cruciate ligament quality -of-life scores ; secondary : International K 
    Output:
    
Overall , ACL reconstructive surgery is safe .
Major complications were uncommon .