xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05994872</url>
    </required_header>
    <id_info>
      <org_study_id>2023-0562</org_study_id>
      <nct_id>NCT05994872</nct_id>
    </id_info>
    <brief_title>Reverse Drilling Technique in Improving Outcomes After Arthroscopic Anterior Cruciate Ligament Reconstruction</brief_title>
    <official_title>A Randomized Controlled Trial of Reverse Drilling Technique in Improving Outcomes After Arthroscopic Anterior Cruciate Ligament Reconstruction: a Prospective, Multicenter, Single-blind, Randomized Controlled Surgical Trial</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Second Affiliated Hospital, School of Medicine, Zhejiang University</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
      <collaborator>
        <agency>Ningbo Medical Center Lihuili Hospital</agency>
        <agency_class>Other</agency_class>
      </collaborator>
      <collaborator>
        <agency>Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University</agency>
        <agency_class>Other</agency_class>
      </collaborator>
      <collaborator>
        <agency>Shaoxing Traditional Chinese Medicine Hospital</agency>
        <agency_class>Other</agency_class>
      </collaborator>
      <collaborator>
        <agency>Lishui Municipal Central Hospital</agency>
        <agency_class>Other</agency_class>
      </collaborator>
      <collaborator>
        <agency>The First People's Hospital of Huzhou</agency>
        <agency_class>Other</agency_class>
      </collaborator>
      <collaborator>
        <agency>Jiande First People's Hospital</agency>
        <agency_class>Other</agency_class>
      </collaborator>
    </sponsors>
    <source>Second Affiliated Hospital, School of Medicine, Zhejiang University</source>
    <oversight_info>
      <has_dmc>Yes</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
    </oversight_info>
    <brief_summary>
      <textblock>
        Anterior cruciate ligament (ACL) injuries and bone tunnel enlargement (BTE) after ACL&#xD;
        reconstruction (ACLR) remain frequent issues. Bone dust (BD) produced by tunnel preparation&#xD;
        with osteogenic ability and reverse drilling (RD), an easy compaction technique, make it&#xD;
        accessible to enhance tendon-bone healing in ACLR. We hyposize that RD and BD synergistically&#xD;
        improve outcomes after arthroscopic ACLR by improving peritunnel bone and preventing BTE.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        Compaction technique can create a denser bone tunnel wall with more cancellous bone&#xD;
        autografting in situ by sequentially compressing cancellous bone trabeculae to bone tunnel&#xD;
        walls, in contrast to conventional extraction reaming by which an enlarged gap is created and&#xD;
        initial direct integration is limited between implants and bone, as chunks of cancellous bone&#xD;
        are torn out, thereby being removed outside the tunnel. Biologically, a compaction technique&#xD;
        was reported to increase the bone volume around grafts and provide a larger area of&#xD;
        bone-to-graft contact for bone integration because of the spring-back effect. Mechanically,&#xD;
        compaction of the bone graft into the femoral tunnel was reported to significantly increase&#xD;
        stiffness of the grafts. Reverse drilling (RD) can compress peritunnel bone at the time of&#xD;
        bone tunnel preparation to make the tunnel wall denser and smoother in comparison with&#xD;
        extraction drilling (ED), reverse drilling yields the same compaction effect as the&#xD;
        compaction technique. Bone dust (BD) is commonly defined as pieces of bone produced by a&#xD;
        power-driven tool. It is universally accepted that bone debris more than 200 mm in particle&#xD;
        size is classified as particulate bone and that bone debris no more than 200 mm is classified&#xD;
        as BD. When applied for ACLR, BD could fully utilize the advantages of an autologous bone&#xD;
        graft while avoiding invasive and traumatic bone harvesting procedures, as bone tunnel&#xD;
        preparation is accompanied by the production of a considerable amount of BD. Therefore, BD&#xD;
        grafting is promising for improving tendon-bone healing with safety and simplification. We&#xD;
        refer to the technique of retaining BD in the bone tunnel after RD as the reverse drilling&#xD;
        technique. We hyposize that reverse drilling technique can improve outcomes after&#xD;
        arthroscopic anterior cruciate ligament reconstruction by improving peritunnel bone and&#xD;
        preventing bone tunnel enlargement.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Not yet recruiting</overall_status>
    <start_date type="Anticipated">May 31, 2024</start_date>
    <completion_date type="Anticipated">December 31, 2027</completion_date>
    <primary_completion_date type="Anticipated">May 31, 2027</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <primary_purpose>Treatment</primary_purpose>
      <masking>Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)</masking>
      <masking_description>Surgical doctor team, patient, outcome assessor, data analyst and image reviewer are masked.</masking_description>
    </study_design_info>
    <primary_outcome>
      <measure>IKDC Subjective Score</measure>
      <time_frame>Patients will be followed up regularly at 3, 6, 9, 12, and 24 months after surgery.</time_frame>
      <description>This table consists of knee joint assessment (10 items) and knee ligament examination (8 items), which includes joint pain, exercise level, and daily activity ability, with a total score of 0-100 points.</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Bone tunnel enlargement</measure>
      <time_frame>Patients will be followed up regularly at 3, 6, 9, 12, and 24 months after surgery.</time_frame>
      <description>Measurement of bone tunnel enlargement through postoperative image</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>Instrumented AP Knee Laxity</measure>
      <time_frame>Patients will be followed up regularly at 3, 6, 9, 12, and 24 months after surgery.</time_frame>
      <description>Arthrometer testing (KT-1000; MEDMetric) was used to measure the anterior displacement of the tibia with respect to the femur under 130 N of applied anterior force and performed in duplicate on each leg.</description>
    </secondary_outcome>
    <number_of_arms>2</number_of_arms>
    <enrollment type="Anticipated">216</enrollment>
    <condition>Anterior Cruciate Ligament Injuries</condition>
    <arm_group>
      <arm_group_label>Traditional extraction drilling</arm_group_label>
      <arm_group_type>Sham Comparator</arm_group_type>
      <description>A standard hamstring autograft procedure was performed using traditional extraction drilling to prepare bone tunnel (n = 108).</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Reverse drilling technique</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>A standard hamstring autograft procedure was performed using reverse drilling technique to prepare bone tunnel (n = 108).</description>
    </arm_group>
    <intervention>
      <intervention_type>Procedure</intervention_type>
      <intervention_name>Reverse drilling technique</intervention_name>
      <description>A standard hamstring autograft procedure was performed using reverse drilling technique to prepare bone tunnel.</description>
      <arm_group_label>Reverse drilling technique</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Procedure</intervention_type>
      <intervention_name>Traditional extraction drilling</intervention_name>
      <description>A standard hamstring autograft procedure was performed using traditional extraction drilling to prepare bone tunnel.</description>
      <arm_group_label>Traditional extraction drilling</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
          Patients with definite anterior cruciate ligament injuries on imaging or intraoperative&#xD;
          arthroscopy (Sherman grading II and III), plan surgery within 45 days from injury; have&#xD;
          basic literacy skills and unimpeded communication; have a smartphone and are able to use&#xD;
          WeChat; and have been given informed consent and have signed to obtain an informed consent&#xD;
          form, and the process must be in accordance with GCP requirements.&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
          1) Combined with other knee injuries (posterior cruciate ligament injury, patellar&#xD;
          dislocation, osteoarthritis, etc.); 2) Suffering from systemic immune diseases; 3) Presence&#xD;
          of other diseases or inflammatory diseases of the knee, including osteoarthritis, cervical&#xD;
          spondylosis, rheumatoid arthritis, fibromyalgia, and rheumatic polymyalgia, etc.; 4)&#xD;
          Patients who have had localized hormone injection therapy within 3 months; 5) Those who&#xD;
          have participated in a clinical trials or are undergoing other clinical trials; 6) Those&#xD;
          with severe primary cardiovascular lesions, pulmonary diseases, endocrine and metabolic&#xD;
          diseases or serious diseases affecting their survival, such as tumors or AIDS, which in the&#xD;
          opinion of the investigator are not suitable for enrollment; 7) Those with severe hepatic&#xD;
          lesions, renal lesions, and hematologic lesions, such as renal function exceeding the upper&#xD;
          limit of normal values and hepatic function exceeding two times the upper limit of normal&#xD;
          values; and 8) Those with viral hepatitis, infectious diseases, severe abnormalities of&#xD;
          coagulation mechanism and other diseases that the investigator considers inappropriate for&#xD;
          surgery; 9) Pregnant or lactating women, or those who plan to conceive during the follow-up&#xD;
          period, with a positive result of urinary human chorionic gonadotropin test prior to&#xD;
          sampling; menstruating women should wait until the end of their menstruation period to&#xD;
          undergo the surgery; 10) Patients with severe neurological or psychiatric disorders; 11)&#xD;
          Those with a suspected or confirmed alcoholic substance abuse history; 12) Vulnerable&#xD;
          groups: mentally ill, critically ill patients, pregnant women, illiterate, minors,&#xD;
          cognitively impaired.&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>18 Years</minimum_age>
      <maximum_age>55 Years</maximum_age>
      <healthy_volunteers>No</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>Haobo Wu, MD</last_name>
      <role>Study Chair</role>
      <affiliation>2nd Affiliated Hospital, School of Medicine, Zhejiang University, China</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>Haobo Wu, MD</last_name>
      <phone>+86 13958122387</phone>
      <email>2505014@zju.edu.cn</email>
    </overall_contact>
    <overall_contact_backup>
      <last_name>An Liu, MD</last_name>
      <email>la@zju.edu.cn</email>
    </overall_contact_backup>
    <location>
      <facility>
        <name>The First People's Hospital of Huzhou</name>
        <address>
          <city>Huzhou</city>
          <state>Zhejiang</state>
          <zip>313000</zip>
          <country>China</country>
        </address>
      </facility>
      <contact>
        <last_name>Zhanfeng Zhang, MD</last_name>
      </contact>
    </location>
    <location>
      <facility>
        <name>Jiande First People's Hospital</name>
        <address>
          <city>Jiande</city>
          <state>Zhejiang</state>
          <zip>311600</zip>
          <country>China</country>
        </address>
      </facility>
      <contact>
        <last_name>Jie Xiao, MD</last_name>
      </contact>
    </location>
    <location>
      <facility>
        <name>Lishui Municipal Central Hospital</name>
        <address>
          <city>Lishui</city>
          <state>Zhejiang</state>
          <zip>323000</zip>
          <country>China</country>
        </address>
      </facility>
      <contact>
        <last_name>Weidong Wu, MD</last_name>
      </contact>
    </location>
    <location>
      <facility>
        <name>Ningbo Medical Center Lihuili Hospital</name>
        <address>
          <city>Ningbo</city>
          <state>Zhejiang</state>
          <zip>315000</zip>
          <country>China</country>
        </address>
      </facility>
      <contact>
        <last_name>Jin Li, MD</last_name>
      </contact>
    </location>
    <location>
      <facility>
        <name>Shaoxing Traditional Chinese Medicine Hospital</name>
        <address>
          <city>Shaoxing</city>
          <state>Zhejiang</state>
          <zip>312000</zip>
          <country>China</country>
        </address>
      </facility>
      <contact>
        <last_name>Jianzeng Shen, MD</last_name>
      </contact>
    </location>
    <location>
      <facility>
        <name>Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University</name>
        <address>
          <city>Taizhou</city>
          <state>Zhejiang</state>
          <zip>318000</zip>
          <country>China</country>
        </address>
      </facility>
      <contact>
        <last_name>Xiaobo Zhou, MD</last_name>
      </contact>
    </location>
    <location_countries>
      <country>China</country>
    </location_countries>
    <results_reference>
      <citation>Hoogeslag RAG, Huis In 't Veld R, Brouwer RW, de Graaff F, Verdonschot N. Acute Anterior Cruciate Ligament Rupture: Repair or Reconstruction? Five-Year Results of a Randomized Controlled Clinical Trial. Am J Sports Med. 2022 Jun;50(7):1779-1787. doi: 10.1177/03635465221090527. Epub 2022 Apr 29.</citation>
      <PMID>35486517</PMID>
    </results_reference>
    <results_reference>
      <citation>Murray MM, Fleming BC, Badger GJ; BEAR Trial Team; Freiberger C, Henderson R, Barnett S, Kiapour A, Ecklund K, Proffen B, Sant N, Kramer DE, Micheli LJ, Yen YM. Bridge-Enhanced Anterior Cruciate Ligament Repair Is Not Inferior to Autograft Anterior Cruciate Ligament Reconstruction at 2 Years: Results of a Prospective Randomized Clinical Trial. Am J Sports Med. 2020 May;48(6):1305-1315. doi: 10.1177/0363546520913532. Epub 2020 Apr 16.</citation>
      <PMID>32298131</PMID>
    </results_reference>
    <results_reference>
      <citation>Beard DJ, Davies L, Cook JA, Stokes J, Leal J, Fletcher H, Abram S, Chegwin K, Greshon A, Jackson W, Bottomley N, Dodd M, Bourke H, Shirkey BA, Paez A, Lamb SE, Barker K, Phillips M, Brown M, Lythe V, Mirza B, Carr A, Monk P, Morgado Areia C, O'Leary S, Haddad F, Wilson C, Price A; ACL SNNAP Study Group. Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial. Lancet. 2022 Aug 20;400(10352):605-615. doi: 10.1016/S0140-6736(22)01424-6.</citation>
      <PMID>35988569</PMID>
    </results_reference>
    <results_reference>
      <citation>Fauno P, Kaalund S. Tunnel widening after hamstring anterior cruciate ligament reconstruction is influenced by the type of graft fixation used: a prospective randomized study. Arthroscopy. 2005 Nov;21(11):1337-41. doi: 10.1016/j.arthro.2005.08.023.</citation>
      <PMID>16325084</PMID>
    </results_reference>
    <results_reference>
      <citation>Weber AE, Delos D, Oltean HN, Vadasdi K, Cavanaugh J, Potter HG, Rodeo SA. Tibial and Femoral Tunnel Changes After ACL Reconstruction: A Prospective 2-Year Longitudinal MRI Study. Am J Sports Med. 2015 May;43(5):1147-56. doi: 10.1177/0363546515570461. Epub 2015 Feb 13.</citation>
      <PMID>25681503</PMID>
    </results_reference>
    <results_reference>
      <citation>Yang W, Li C, Ji X, Yao M, Hong J, Qu Z, Liu A, Wu H. Synergistic Effect of Reverse Drilling and Bone Dust on Femoral Tendon-Bone Healing After Anterior Cruciate Ligament Reconstruction in a Rabbit Model. Am J Sports Med. 2022 Dec;50(14):3844-3855. doi: 10.1177/03635465221129267. Epub 2022 Nov 3.</citation>
      <PMID>36326437</PMID>
    </results_reference>
    <verification_date>August 2023</verification_date>
    <study_first_submitted>August 9, 2023</study_first_submitted>
    <study_first_submitted_qc>August 9, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 16, 2023</study_first_posted>
    <last_update_submitted>August 9, 2023</last_update_submitted>
    <last_update_submitted_qc>August 9, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 16, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Sponsor</responsible_party_type>
    </responsible_party>
    <keyword>Reverse drilling technique</keyword>
    <keyword>Anterior cruciate ligament reconstruction</keyword>
    <keyword>Tendon-to-bone healing</keyword>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Anterior Cruciate Ligament Injuries</mesh_term>
    </condition_browse>
    <patient_data>
      <sharing_ipd>No</sharing_ipd>
    </patient_data>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05994872
  org study id: 2023-0562
  nct id: NCT05994872
  lead sponsor: 
  collaborator: 
  collaborator: 
  collaborator: 
  collaborator: 
  collaborator: 
  collaborator: 
  has dmc: Yes
  is fda regulated drug: No
  is fda regulated device: No
  Anterior cruciate ligament (ACL) injuries and bone tunnel enlargement (BTE) after ACL
        reconstruction (ACLR) remain frequent issues. Bone dust (BD) produced by tunnel preparation
        with osteogenic ability and reverse drilling (RD), an easy compaction technique, make it
        accessible to enhance tendon-bone healing in ACLR. We hyposize that RD and BD synergistically
        improve outcomes after arthroscopic ACLR by improving peritunnel bone and preventing BTE.
  Compaction technique can create a denser bone tunnel wall with more cancellous bone
        autografting in situ by sequentially compressing cancellous bone trabeculae to bone tunnel
        walls, in contrast to conventional extraction reaming by which an enlarged gap is created and
        initial direct integration is limited between implants and bone, as chunks of cancellous bone
        are torn out, thereby being removed outside the tunnel. Biologically, a compaction technique
        was reported to increase the bone volume around grafts and provide a larger area of
        bone-to-graft contact for bone integration because of the spring-back effect. Mechanically,
        compaction of the bone graft into the femoral tunnel was reported to significantly increase
        stiffness of the grafts. Reverse drilling (RD) can compress peritunnel bone at the time of
        bone tunnel preparation to make the tunnel wall denser and smoother in comparison with
        extraction drilling (ED), reverse drilling yields the same compaction effect as the
        compaction technique. Bone dust (BD) is commonly defined as pieces of bone produced by a
        power-driven tool. It is universally accepted that bone debris more than 200 mm in particle
        size is classified as particulate bone and that bone debris no more than 200 mm is classified
        as BD. When applied for ACLR, BD could fully utilize the advantages of an autologous bone
        graft while avoiding invasive and traumatic bone harvesting procedures, as bone tunnel
        preparation is accompanied by the production of a considerable amount of BD. Therefore, BD
        grafting is promising for improving tendon-bone healing with safety and simplification. We
        refer to the technique of retaining BD in the bone tunnel after RD as the reverse drilling
        technique. We hyposize that reverse drilling technique can improve outcomes after
        arthroscopic anterior cruciate ligament reconstruction by improving peritunnel bone and
        preventing bone tunnel enlargement.
  allocation: Randomized
  intervention model: Parallel Assignment
  primary purpose: Treatment
  masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
  masking description: Surgical doctor team, patient, outcome assessor, data analyst and image reviewer are masked.
  measure: IKDC Subjective Score
  time frame: Patients will be followed up regularly at 3, 6, 9, 12, and 24 months after surgery.
  description: This table consists of knee joint assessment (10 items) and knee ligament examination (8 items), which includes joint pain, exercise level, and daily activity ability, with a total score of 0-100 points.
  measure: Bone tunnel enlargement
  time frame: Patients will be followed up regularly at 3, 6, 9, 12, and 24 months after surgery.
  description: Measurement of bone tunnel enlargement through postoperative image
  measure: Instrumented AP Knee Laxity
  time frame: Patients will be followed up regularly at 3, 6, 9, 12, and 24 months after surgery.
  description: Arthrometer testing (KT-1000; MEDMetric) was used to measure the anterior displacement of the tibia with respect to the femur under 130 N of applied anterior force and performed in duplicate on each leg.
  arm group label: Traditional extraction drilling
  arm group type: Sham Comparator
  description: A standard hamstring autograft procedure was performed using traditional extraction drilling to prepare bone tunnel (n = 108).
  arm group label: Reverse drilling technique
  arm group type: Experimental
  description: A standard hamstring autograft procedure was performed using reverse drilling technique to prepare bone tunnel (n = 108).
  intervention type: Procedure
  intervention name: Reverse drilling technique
  description: A standard hamstring autograft procedure was performed using reverse drilling technique to prepare bone tunnel.
  arm group label: Reverse drilling technique
  intervention type: Procedure
  intervention name: Traditional extraction drilling
  description: A standard hamstring autograft procedure was performed using traditional extraction drilling to prepare bone tunnel.
  arm group label: Traditional extraction drilling
  criteria: 
  gender: All
  minimum age: 18 Years
  maximum age: 55 Years
  healthy volunteers: No
  last name: Haobo Wu, MD
  role: Study Chair
  affiliation: 2nd Affiliated Hospital, School of Medicine, Zhejiang University, China
  last name: Haobo Wu, MD
  phone: +86 13958122387
  email: 2505014@zju.edu.cn
  last name: An Liu, MD
  email: la@zju.edu.cn
  facility: 
  contact: 
  facility: 
  contact: 
  facility: 
  contact: 
  facility: 
  contact: 
  facility: 
  contact: 
  facility: 
  contact: 
  country: China
  citation: Hoogeslag RAG, Huis In 't Veld R, Brouwer RW, de Graaff F, Verdonschot N. Acute Anterior Cruciate Ligament Rupture: Repair or Reconstruction? Five-Year Results of a Randomized Controlled Clinical Trial. Am J Sports Med. 2022 Jun;50(7):1779-1787. doi: 10.1177/03635465221090527. Epub 2022 Apr 29.
  PMID: 35486517
  citation: Murray MM, Fleming BC, Badger GJ; BEAR Trial Team; Freiberger C, Henderson R, Barnett S, Kiapour A, Ecklund K, Proffen B, Sant N, Kramer DE, Micheli LJ, Yen YM. Bridge-Enhanced Anterior Cruciate Ligament Repair Is Not Inferior to Autograft Anterior Cruciate Ligament Reconstruction at 2 Years: Results of a Prospective Randomized Clinical Trial. Am J Sports Med. 2020 May;48(6):1305-1315. doi: 10.1177/0363546520913532. Epub 2020 Apr 16.
  PMID: 32298131
  citation: Beard DJ, Davies L, Cook JA, Stokes J, Leal J, Fletcher H, Abram S, Chegwin K, Greshon A, Jackson W, Bottomley N, Dodd M, Bourke H, Shirkey BA, Paez A, Lamb SE, Barker K, Phillips M, Brown M, Lythe V, Mirza B, Carr A, Monk P, Morgado Areia C, O'Leary S, Haddad F, Wilson C, Price A; ACL SNNAP Study Group. Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial. Lancet. 2022 Aug 20;400(10352):605-615. doi: 10.1016/S0140-6736(22)01424-6.
  PMID: 35988569
  citation: Fauno P, Kaalund S. Tunnel widening after hamstring anterior cruciate ligament reconstruction is influenced by the type of graft fixation used: a prospective randomized study. Arthroscopy. 2005 Nov;21(11):1337-41. doi: 10.1016/j.arthro.2005.08.023.
  PMID: 16325084
  citation: Weber AE, Delos D, Oltean HN, Vadasdi K, Cavanaugh J, Potter HG, Rodeo SA. Tibial and Femoral Tunnel Changes After ACL Reconstruction: A Prospective 2-Year Longitudinal MRI Study. Am J Sports Med. 2015 May;43(5):1147-56. doi: 10.1177/0363546515570461. Epub 2015 Feb 13.
  PMID: 25681503
  citation: Yang W, Li C, Ji X, Yao M, Hong J, Qu Z, Liu A, Wu H. Synergistic Effect of Reverse Drilling and Bone Dust on Femoral Tendon-Bone Healing After Anterior Cruciate Ligament Reconstruction in a Rabbit Model. Am J Sports Med. 2022 Dec;50(14):3844-3855. doi: 10.1177/03635465221129267. Epub 2022 Nov 3.
  PMID: 36326437
  responsible party type: Sponsor
  mesh term: Anterior Cruciate Ligament Injuries
  sharing ipd: No