Chronicity of Anterior Cruciate Ligament Deficiency, Part 2: Radiographic Predictors of Early Graft Failure
Background: Accumulating evidence suggests that long-term anterior cruciate ligament (ACL) deficiency can give rise to an abnormal tibiofemoral relationship and subsequent intra-articular lesions. However, the effects of chronic ACL deficiency (ACLD) on early graft failure after anatomic reconstruct...
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| Veröffentlicht in: | Orthopaedic journal of sports medicine 2018-02, Vol.6 (2), p.2325967117751915-2325967117751915 |
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| creator | Tanaka, Yoshinari Kita, Keisuke Takao, Rikio Amano, Hiroshi Uchida, Ryohei Shiozaki, Yoshiki Yonetani, Yasukazu Kinugasa, Kazutaka Mae, Tatsuo Horibe, Shuji |
| description | Background:
Accumulating evidence suggests that long-term anterior cruciate ligament (ACL) deficiency can give rise to an abnormal tibiofemoral relationship and subsequent intra-articular lesions. However, the effects of chronic ACL deficiency (ACLD) on early graft failure after anatomic reconstruction remain unclear.
Hypothesis:
We hypothesized that patients with long-term ACLD lasting more than 5 years would have a greater rate of early graft failure due to insufficient intraoperative reduction of the tibia and that the preoperative and immediately postoperative abnormal tibiofemoral relationship in the sagittal plane, such as anterior tibial subluxation (ATS), would correlate with the graft status on postoperative magnetic resonance imaging (MRI).
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A total of 358 patients who had undergone anatomic ACL reconstruction with hamstring grafts were divided into 5 groups based on chronicity of ACLD: (1) 0 to 6 months, (2) 6 months to 1 year, (3) 1 to 2 years, (4) 2 to 5 years, and (5) longer than 5 years. Preoperatively and immediately postoperatively, lateral radiographs in full extension were taken in all patients to evaluate the tibiofemoral relationship, specifically with regard to ATS, space for the ACL (sACL), and extension angle. All patients underwent MRI at 6 months to reveal graft status. Groups with a high rate of graft failure were further analyzed to compare demographic and radiographic factors between the intact and failure subgroups, followed by multivariate logistic regression analysis to identify predisposing factors.
Results:
Graft failure without trauma was observed in 4 (1.8%), 0 (0%), 1 (3.7%), 3 (9.7%), and 8 patients (17.7%) in groups 1, 2, 3, 4, and 5, respectively. Of the 76 patients in groups 4 and 5, significant differences were noted between the failure and intact subgroups in preoperative ATS (4.9 vs 2.4 mm, respectively; P < .01), side-to-side differences in sACL (sACL-SSD) (4.7 vs 1.9 mm, respectively; P < .01), extension deficit (4.4° vs 1.3°, respectively; P < .01), and chondral lesions (P = .02), while postoperative ATS and sACL-SSD showed no differences. Multivariate logistic regression analysis revealed that of these factors, preoperative sACL-SSD could be a risk factor for early graft failure (odds ratio, 3.2; 95% CI, 1.37-7.46).
Conclusion
Early graft failure at 6 months increased in patients with ACLD longer than 2 years. In this population, preoperative sACL-SSD |
| doi_str_mv | 10.1177/2325967117751915 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5818097</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_2325967117751915</sage_id><sourcerecordid>2008361487</sourcerecordid><originalsourceid>FETCH-LOGICAL-c462t-a5a1d2542c21d23a5359e3784ed6f3e749098a4b64c27efc543b4c1cd255c2de3</originalsourceid><addsrcrecordid>eNp1kd9rFDEQx4MottS--yQBX3zo6ubX_vBBKGdbhQOL6HOYy87epe5tzklWuP--Wa6ttWBeZph85puZfBl7Lcr3QtT1B6mkaat6zo1ohXnGjudSMdeeP8qP2GmMN2U-TeZU_ZIdyVbXrdHqmP1abCiM3vm056Hn52NC8oH4gibnISFf-jVscUz8M_YZw9Htz_g1UOLyI_8OnQ9rgt3GO35N2HmXAsVZ6QJo2PMrgj7xS_DDRPiKvehhiHh6F0_Yz8uLH4svxfLb1dfF-bJwupKpAAOik0ZLJ3NUYJRpUdWNxq7qFda6LdsG9KrSTtbYu7zHSjvhco9xskN1wj4ddHfTaoudy9MTDHZHfgu0twG8_fdm9Bu7Dn-saURTtnUWeHcnQOH3hDHZrY8OhwFGDFO0Mn-lqoRuZvTtE_QmTDTm9axUIk-d3SkzVR4oRyFGwv5hGFHa2UD71Mzc8ubxEg8N99ZloDgAEdb499X_Ct4CukimuA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2313781770</pqid></control><display><type>article</type><title>Chronicity of Anterior Cruciate Ligament Deficiency, Part 2: Radiographic Predictors of Early Graft Failure</title><source>DOAJ Directory of Open Access Journals</source><source>Sage Journals GOLD Open Access 2024</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Tanaka, Yoshinari ; Kita, Keisuke ; Takao, Rikio ; Amano, Hiroshi ; Uchida, Ryohei ; Shiozaki, Yoshiki ; Yonetani, Yasukazu ; Kinugasa, Kazutaka ; Mae, Tatsuo ; Horibe, Shuji</creator><creatorcontrib>Tanaka, Yoshinari ; Kita, Keisuke ; Takao, Rikio ; Amano, Hiroshi ; Uchida, Ryohei ; Shiozaki, Yoshiki ; Yonetani, Yasukazu ; Kinugasa, Kazutaka ; Mae, Tatsuo ; Horibe, Shuji</creatorcontrib><description>Background:
Accumulating evidence suggests that long-term anterior cruciate ligament (ACL) deficiency can give rise to an abnormal tibiofemoral relationship and subsequent intra-articular lesions. However, the effects of chronic ACL deficiency (ACLD) on early graft failure after anatomic reconstruction remain unclear.
Hypothesis:
We hypothesized that patients with long-term ACLD lasting more than 5 years would have a greater rate of early graft failure due to insufficient intraoperative reduction of the tibia and that the preoperative and immediately postoperative abnormal tibiofemoral relationship in the sagittal plane, such as anterior tibial subluxation (ATS), would correlate with the graft status on postoperative magnetic resonance imaging (MRI).
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A total of 358 patients who had undergone anatomic ACL reconstruction with hamstring grafts were divided into 5 groups based on chronicity of ACLD: (1) 0 to 6 months, (2) 6 months to 1 year, (3) 1 to 2 years, (4) 2 to 5 years, and (5) longer than 5 years. Preoperatively and immediately postoperatively, lateral radiographs in full extension were taken in all patients to evaluate the tibiofemoral relationship, specifically with regard to ATS, space for the ACL (sACL), and extension angle. All patients underwent MRI at 6 months to reveal graft status. Groups with a high rate of graft failure were further analyzed to compare demographic and radiographic factors between the intact and failure subgroups, followed by multivariate logistic regression analysis to identify predisposing factors.
Results:
Graft failure without trauma was observed in 4 (1.8%), 0 (0%), 1 (3.7%), 3 (9.7%), and 8 patients (17.7%) in groups 1, 2, 3, 4, and 5, respectively. Of the 76 patients in groups 4 and 5, significant differences were noted between the failure and intact subgroups in preoperative ATS (4.9 vs 2.4 mm, respectively; P < .01), side-to-side differences in sACL (sACL-SSD) (4.7 vs 1.9 mm, respectively; P < .01), extension deficit (4.4° vs 1.3°, respectively; P < .01), and chondral lesions (P = .02), while postoperative ATS and sACL-SSD showed no differences. Multivariate logistic regression analysis revealed that of these factors, preoperative sACL-SSD could be a risk factor for early graft failure (odds ratio, 3.2; 95% CI, 1.37-7.46).
Conclusion
Early graft failure at 6 months increased in patients with ACLD longer than 2 years. In this population, preoperative sACL-SSD was the most significant risk factor for early graft failure on MRI. However, immediately postoperative radiographic measurements had no effect on graft failure rates.</description><identifier>ISSN: 2325-9671</identifier><identifier>EISSN: 2325-9671</identifier><identifier>DOI: 10.1177/2325967117751915</identifier><identifier>PMID: 29479543</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Knee ; NMR ; Nuclear magnetic resonance ; Orthopedics ; Regression analysis ; Sports medicine</subject><ispartof>Orthopaedic journal of sports medicine, 2018-02, Vol.6 (2), p.2325967117751915-2325967117751915</ispartof><rights>The Author(s) 2018</rights><rights>The Author(s) 2018. This work is licensed under the Creative Commons Attribution – Non-Commercial – No Derivatives License http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2018 2018 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-a5a1d2542c21d23a5359e3784ed6f3e749098a4b64c27efc543b4c1cd255c2de3</citedby><cites>FETCH-LOGICAL-c462t-a5a1d2542c21d23a5359e3784ed6f3e749098a4b64c27efc543b4c1cd255c2de3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818097/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818097/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,21966,27853,27924,27925,44945,45333,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29479543$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tanaka, Yoshinari</creatorcontrib><creatorcontrib>Kita, Keisuke</creatorcontrib><creatorcontrib>Takao, Rikio</creatorcontrib><creatorcontrib>Amano, Hiroshi</creatorcontrib><creatorcontrib>Uchida, Ryohei</creatorcontrib><creatorcontrib>Shiozaki, Yoshiki</creatorcontrib><creatorcontrib>Yonetani, Yasukazu</creatorcontrib><creatorcontrib>Kinugasa, Kazutaka</creatorcontrib><creatorcontrib>Mae, Tatsuo</creatorcontrib><creatorcontrib>Horibe, Shuji</creatorcontrib><title>Chronicity of Anterior Cruciate Ligament Deficiency, Part 2: Radiographic Predictors of Early Graft Failure</title><title>Orthopaedic journal of sports medicine</title><addtitle>Orthop J Sports Med</addtitle><description>Background:
Accumulating evidence suggests that long-term anterior cruciate ligament (ACL) deficiency can give rise to an abnormal tibiofemoral relationship and subsequent intra-articular lesions. However, the effects of chronic ACL deficiency (ACLD) on early graft failure after anatomic reconstruction remain unclear.
Hypothesis:
We hypothesized that patients with long-term ACLD lasting more than 5 years would have a greater rate of early graft failure due to insufficient intraoperative reduction of the tibia and that the preoperative and immediately postoperative abnormal tibiofemoral relationship in the sagittal plane, such as anterior tibial subluxation (ATS), would correlate with the graft status on postoperative magnetic resonance imaging (MRI).
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A total of 358 patients who had undergone anatomic ACL reconstruction with hamstring grafts were divided into 5 groups based on chronicity of ACLD: (1) 0 to 6 months, (2) 6 months to 1 year, (3) 1 to 2 years, (4) 2 to 5 years, and (5) longer than 5 years. Preoperatively and immediately postoperatively, lateral radiographs in full extension were taken in all patients to evaluate the tibiofemoral relationship, specifically with regard to ATS, space for the ACL (sACL), and extension angle. All patients underwent MRI at 6 months to reveal graft status. Groups with a high rate of graft failure were further analyzed to compare demographic and radiographic factors between the intact and failure subgroups, followed by multivariate logistic regression analysis to identify predisposing factors.
Results:
Graft failure without trauma was observed in 4 (1.8%), 0 (0%), 1 (3.7%), 3 (9.7%), and 8 patients (17.7%) in groups 1, 2, 3, 4, and 5, respectively. Of the 76 patients in groups 4 and 5, significant differences were noted between the failure and intact subgroups in preoperative ATS (4.9 vs 2.4 mm, respectively; P < .01), side-to-side differences in sACL (sACL-SSD) (4.7 vs 1.9 mm, respectively; P < .01), extension deficit (4.4° vs 1.3°, respectively; P < .01), and chondral lesions (P = .02), while postoperative ATS and sACL-SSD showed no differences. Multivariate logistic regression analysis revealed that of these factors, preoperative sACL-SSD could be a risk factor for early graft failure (odds ratio, 3.2; 95% CI, 1.37-7.46).
Conclusion
Early graft failure at 6 months increased in patients with ACLD longer than 2 years. In this population, preoperative sACL-SSD was the most significant risk factor for early graft failure on MRI. However, immediately postoperative radiographic measurements had no effect on graft failure rates.</description><subject>Knee</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Orthopedics</subject><subject>Regression analysis</subject><subject>Sports medicine</subject><issn>2325-9671</issn><issn>2325-9671</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1kd9rFDEQx4MottS--yQBX3zo6ubX_vBBKGdbhQOL6HOYy87epe5tzklWuP--Wa6ttWBeZph85puZfBl7Lcr3QtT1B6mkaat6zo1ohXnGjudSMdeeP8qP2GmMN2U-TeZU_ZIdyVbXrdHqmP1abCiM3vm056Hn52NC8oH4gibnISFf-jVscUz8M_YZw9Htz_g1UOLyI_8OnQ9rgt3GO35N2HmXAsVZ6QJo2PMrgj7xS_DDRPiKvehhiHh6F0_Yz8uLH4svxfLb1dfF-bJwupKpAAOik0ZLJ3NUYJRpUdWNxq7qFda6LdsG9KrSTtbYu7zHSjvhco9xskN1wj4ddHfTaoudy9MTDHZHfgu0twG8_fdm9Bu7Dn-saURTtnUWeHcnQOH3hDHZrY8OhwFGDFO0Mn-lqoRuZvTtE_QmTDTm9axUIk-d3SkzVR4oRyFGwv5hGFHa2UD71Mzc8ubxEg8N99ZloDgAEdb499X_Ct4CukimuA</recordid><startdate>20180216</startdate><enddate>20180216</enddate><creator>Tanaka, Yoshinari</creator><creator>Kita, Keisuke</creator><creator>Takao, Rikio</creator><creator>Amano, Hiroshi</creator><creator>Uchida, Ryohei</creator><creator>Shiozaki, Yoshiki</creator><creator>Yonetani, Yasukazu</creator><creator>Kinugasa, Kazutaka</creator><creator>Mae, Tatsuo</creator><creator>Horibe, Shuji</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180216</creationdate><title>Chronicity of Anterior Cruciate Ligament Deficiency, Part 2: Radiographic Predictors of Early Graft Failure</title><author>Tanaka, Yoshinari ; Kita, Keisuke ; Takao, Rikio ; Amano, Hiroshi ; Uchida, Ryohei ; Shiozaki, Yoshiki ; Yonetani, Yasukazu ; Kinugasa, Kazutaka ; Mae, Tatsuo ; Horibe, Shuji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-a5a1d2542c21d23a5359e3784ed6f3e749098a4b64c27efc543b4c1cd255c2de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Knee</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Orthopedics</topic><topic>Regression analysis</topic><topic>Sports medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tanaka, Yoshinari</creatorcontrib><creatorcontrib>Kita, Keisuke</creatorcontrib><creatorcontrib>Takao, Rikio</creatorcontrib><creatorcontrib>Amano, Hiroshi</creatorcontrib><creatorcontrib>Uchida, Ryohei</creatorcontrib><creatorcontrib>Shiozaki, Yoshiki</creatorcontrib><creatorcontrib>Yonetani, Yasukazu</creatorcontrib><creatorcontrib>Kinugasa, Kazutaka</creatorcontrib><creatorcontrib>Mae, Tatsuo</creatorcontrib><creatorcontrib>Horibe, Shuji</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Orthopaedic journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tanaka, Yoshinari</au><au>Kita, Keisuke</au><au>Takao, Rikio</au><au>Amano, Hiroshi</au><au>Uchida, Ryohei</au><au>Shiozaki, Yoshiki</au><au>Yonetani, Yasukazu</au><au>Kinugasa, Kazutaka</au><au>Mae, Tatsuo</au><au>Horibe, Shuji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chronicity of Anterior Cruciate Ligament Deficiency, Part 2: Radiographic Predictors of Early Graft Failure</atitle><jtitle>Orthopaedic journal of sports medicine</jtitle><addtitle>Orthop J Sports Med</addtitle><date>2018-02-16</date><risdate>2018</risdate><volume>6</volume><issue>2</issue><spage>2325967117751915</spage><epage>2325967117751915</epage><pages>2325967117751915-2325967117751915</pages><issn>2325-9671</issn><eissn>2325-9671</eissn><abstract>Background:
Accumulating evidence suggests that long-term anterior cruciate ligament (ACL) deficiency can give rise to an abnormal tibiofemoral relationship and subsequent intra-articular lesions. However, the effects of chronic ACL deficiency (ACLD) on early graft failure after anatomic reconstruction remain unclear.
Hypothesis:
We hypothesized that patients with long-term ACLD lasting more than 5 years would have a greater rate of early graft failure due to insufficient intraoperative reduction of the tibia and that the preoperative and immediately postoperative abnormal tibiofemoral relationship in the sagittal plane, such as anterior tibial subluxation (ATS), would correlate with the graft status on postoperative magnetic resonance imaging (MRI).
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A total of 358 patients who had undergone anatomic ACL reconstruction with hamstring grafts were divided into 5 groups based on chronicity of ACLD: (1) 0 to 6 months, (2) 6 months to 1 year, (3) 1 to 2 years, (4) 2 to 5 years, and (5) longer than 5 years. Preoperatively and immediately postoperatively, lateral radiographs in full extension were taken in all patients to evaluate the tibiofemoral relationship, specifically with regard to ATS, space for the ACL (sACL), and extension angle. All patients underwent MRI at 6 months to reveal graft status. Groups with a high rate of graft failure were further analyzed to compare demographic and radiographic factors between the intact and failure subgroups, followed by multivariate logistic regression analysis to identify predisposing factors.
Results:
Graft failure without trauma was observed in 4 (1.8%), 0 (0%), 1 (3.7%), 3 (9.7%), and 8 patients (17.7%) in groups 1, 2, 3, 4, and 5, respectively. Of the 76 patients in groups 4 and 5, significant differences were noted between the failure and intact subgroups in preoperative ATS (4.9 vs 2.4 mm, respectively; P < .01), side-to-side differences in sACL (sACL-SSD) (4.7 vs 1.9 mm, respectively; P < .01), extension deficit (4.4° vs 1.3°, respectively; P < .01), and chondral lesions (P = .02), while postoperative ATS and sACL-SSD showed no differences. Multivariate logistic regression analysis revealed that of these factors, preoperative sACL-SSD could be a risk factor for early graft failure (odds ratio, 3.2; 95% CI, 1.37-7.46).
Conclusion
Early graft failure at 6 months increased in patients with ACLD longer than 2 years. In this population, preoperative sACL-SSD was the most significant risk factor for early graft failure on MRI. However, immediately postoperative radiographic measurements had no effect on graft failure rates.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>29479543</pmid><doi>10.1177/2325967117751915</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Knee NMR Nuclear magnetic resonance Orthopedics Regression analysis Sports medicine |
| title | Chronicity of Anterior Cruciate Ligament Deficiency, Part 2: Radiographic Predictors of Early Graft Failure |
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