Intra‐articular remodelling of hamstring tendon grafts after anterior cruciate ligament reconstruction

Janssen, Rob P. A.; Scheffler, Sven U.

doi:10.1007/s00167-013-2634-5

Cited by 225Knee injuries and reconstruction techniquesTendon Structure and TreatmentPeriodontal Regeneration and Treatments

Intra‐articular remodelling of hamstring tendon grafts after anterior cruciate ligament reconstruction

Open access

Janssen, Rob P. A., Scheffler, Sven U.·2014·Knee Surgery, Sports Traumatology, Arthroscopy

DOI 10.1007/s00167-013-2634-5PMC PMC4142140

Open this paper in CoChat — free account Open PDF

Abstract

Purpose: A summary is provided on the existing knowledge about the specific healing phases of the intra‐articular hamstring tendon graft used for ACL reconstruction. Differences between human and animal in vivo studies are explained, and implications for the postoperative time period are laid out. Methods: A systematic review of the existing literature was performed on the topic of tendon remodelling of hamstring grafts in ACL reconstruction using Medline database. Publications between 1982 and 2012 were included. Special focus was directed on in vivo human and animal studies analysing intra‐articular free tendon graft remodelling. Results: Animal and human in vitro and vivo researches have demonstrated three characteristic stages of graft healing after ACL reconstruction: an early graft healing phase with central graft necrosis and hypocellularity and no detectable revascularization of the graft tissue, followed by a phase of proliferation, the time of most intensive remodelling and revascularization and finally, a ligamentization phase with characteristic restructuring of the graft towards the properties of the intact ACL. However, a full restoration of either the biological or biomechanical properties of the intact ACL is not achieved. Conclusion: Significant knowledge on human cruciate ligament remodelling has been added in the understanding of the processes during the course of graft healing. Most importantly, the remodelling process in humans is prolonged compared to animal studies. While today´s rehabilitation protocols are often extrapolated from findings of animal in vivo healing studies, current findings of human in vivo healing studies might require new post‐operative regimens following hamstring ACL reconstruction.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1007/s00167-013-2634-5

Cites

2 of 2 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

In the early postoperative period, limited ingrowth of newly regenerated connective tissue in the knee cavity restricted ligament regeneration.
“in the early postoperative period, limited ingrowth of the newly regenerated connective tissue in the knee cavity restricted ligament regeneration, and bone tissue in the bone tunnel disrupted graft–bone healing [13, 14].”
From Bone Mesenchymal Stem Cells Contribute to Ligament Regeneration and Graft–Bone Healing after Anterior Cruciate Ligament Reconstruction with Silk–Collagen Scaffold (2021) · cites this paper as [13]
The ‘Early graft healing phase’ section (page unavailable) reports no graft revascularization and says insufficient biological graft incorporation is a weak point in the first four postoperative weeks. It does not say that limited ingrowth of newly regenerated connective tissue in the knee cavity restricts ligament regeneration. (LLM, conf=0.74)
Experimental — accuracy not yet measured
In the early postoperative period, bone tissue in the bone tunnel disrupted graft-bone healing.
“in the early postoperative period, limited ingrowth of the newly regenerated connective tissue in the knee cavity restricted ligament regeneration, and bone tissue in the bone tunnel disrupted graft–bone healing [13, 14].”
From Bone Mesenchymal Stem Cells Contribute to Ligament Regeneration and Graft–Bone Healing after Anterior Cruciate Ligament Reconstruction with Silk–Collagen Scaffold (2021) · cites this paper as [13]
The Early graft healing phase section (page not specified) says that insufficient biological graft incorporation is a weak point at 2–4 weeks, with failures by graft pullout. It does not say that bone tissue in the tunnel disrupted graft–bone healing; the proposed cause is unsupported. (LLM, conf=0.83)
Experimental — accuracy not yet measured
The mechanical properties of an implanted graft, regardless of graft type, do not return to normal after anterior cruciate ligament reconstruction surgery.
“However, the mechanical properties of the implanted graft, regardless of graft type, do not return to normal after ACLR surgery [3–5].”
From A new biological enhancement therapy for anterior cruciate ligament reconstruction: the preclinical proof of anterior cruciate ligament reconstruction with tendon graft reseeded with autologous anterior cruciate ligament-derived cells (2025) · cites this paper as [3]
The Conclusion says hamstring tendon grafts adapt toward the intact ACL without fully restoring its mechanical properties. But the paper focuses on hamstring grafts, and the Human hamstring remodelling and rehabilitation section says no final conclusion can be drawn about mechanical strength in humans. It therefore does not establish the claim for every graft type after ACL reconstruction. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Restoration of the mechanical strength of an intact anterior cruciate ligament is not achieved even after 2 years after anterior cruciate ligament reconstruction.
“Although the implanted graft reportedly undergoes remodeling after 1 year, restoration of the mechanical strength of an intact ACL is not achieved even after 2 years [3, 4].”
From A new biological enhancement therapy for anterior cruciate ligament reconstruction: the preclinical proof of anterior cruciate ligament reconstruction with tendon graft reseeded with autologous anterior cruciate ligament-derived cells (2025) · cites this paper as [3]
The Proliferation phase section says full mechanical strength was not restored even after two years in any in vivo model, in the context of animal studies. The Human hamstring remodelling and rehabilitation section says no final conclusion can be drawn about graft strength in humans because it cannot be measured in vivo. The claim omits that limitation and presents the two-year finding as applying generally after ACL reconstruction. (LLM, conf=0.88)
Experimental — accuracy not yet measured
A tendon graft is often used to perform ACLR; however, the graft undergoes necrosis early in the healing process, and deterioration occurs through the proliferation of the extrinsic fibroblasts in place of graft necrosis, resulting in overexpression of type III collagen.
“A tendon graft is often used to perform ACLR; however, the graft undergoes necrosis early in the healing process, and deterioration occurs through the proliferation of the extrinsic fibroblasts in place of graft necrosis, resulting in overexpression of type III collagen [3, 11].”
From A new biological enhancement therapy for anterior cruciate ligament reconstruction: the preclinical proof of anterior cruciate ligament reconstruction with tendon graft reseeded with autologous anterior cruciate ligament-derived cells (2025) · cites this paper as [3]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Histological Changes in the Human Anterior Cruciate Ligament After Rupture*
MURRAY, M. M., MARTIN, S. D., MARTIN, T. L., & SPECTOR, M. (2000) · The Journal of Bone and Joint Surgery-American Volume · doi:10.2106/00004623-200010000-00004 · Cited by 398 · see citing works
Analysis of a Semitendinosus Autograft in a Rabbit Model
Blickenstaff, K. R., Grana, W. A., & Egle, D. (1997) · The American Journal of Sports Medicine · doi:10.1177/036354659702500420 · Cited by 164 · see citing works

Flagged first, then by citations

Research works printed but not linked: 64

[1]Abe S Kurosaka M Iguchi T Light and electron microscopic study of remodeling and maturation process in autogenous graft for anterior cruciate ligament reconstruction Arthroscopy 1993 9 394 405 10.1016/S0749-8063(05)80313-5 8216570 · DOI
[2]Amiel D Frank C Harwood F Tendons and ligaments: a morphological and biochemical comparison J Orthop Res 1984 1 257 265 10.1002/jor.1100010305 6481509 · DOI
[3]Amiel D Kleiner JB Akeson WH The natural history of the anterior cruciate ligament autograft of patellar tendon origin Am J Sports Med 1986 14 449 462 10.1177/036354658601400603 3799871 · DOI
[4]Amiel D Kleiner JB Roux RD The phenomenon of “ligamentization”: anterior cruciate ligament reconstruction with autogenous patellar tendon J Orthop Res 1986 4 162 172 10.1002/jor.1100040204 3712125 · DOI
[5]Arnoczky SP, Tarvin GB, Marshall JL (1982) Anterior cruciate ligament replacement using patellar tendon. An evaluation of graft revascularization in the dog. J Bone Joint Surg 64-A:217–224 7056776
[6]Ballock RT Woo SL Lyon RM Use of patellar tendon autograft for anterior cruciate ligament reconstruction in the rabbit: a long-term histologic and biomechanical study J Orthop Res 1989 7 474 485 10.1002/jor.1100070404 2738766 · DOI · Paper page
[7]Beynnon BD Uh BS Johnson RJ Rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind comparison of programs administered over 2 different time intervals Am J Sports Med 2005 33 347 359 10.1177/0363546504268406 15716250 · DOI
[8]Beynnon BD Johnson RJ Naud S Accelerated versus nonaccelerated rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double blind investigation evaluating knee joint laxity using stereophotogrammetric analysis Am J Sports Med 2011 39 2536 2548 10.1177/0363546511422349 21952714 · DOI
[10]Claes S Verdonk P Forsyth R The “ligamentization” process in anterior cruciate ligament reconstruction: what happens to the human graft? A systematic review of the literature Am J Sports Med 2011 39 2476 2483 10.1177/0363546511402662 21515806 · DOI · Paper page
[11]Dustmann M Schmidt T Gangey I The extracellular remodeling of free-soft-tissue autografts and allografts for reconstruction of the anterior cruciate ligament: a comparison study in sheep model Knee Surg Sports Traumatol Arthrosc 2008 16 360 369 10.1007/s00167-007-0471-0 18183370 · DOI
[12]Falconiero RP Distefano VJ Cook TM Revascularization and ligamentization of autogenous anterior cruciate ligament grafts in humans Arthroscopy 1998 14 197 205 10.1016/S0749-8063(98)70041-6 9531133 · DOI · Paper page
[13]Figueroa D Melena P Calco R Magnetic resonance imaging evaluation of the integration and maturation of semitendinosus-gracilis graft in anterior cruciate ligament reconstruction using autologous platelet concentrate Arthroscopy 2010 26 1318 1325 10.1016/j.arthro.2010.02.010 20800986 · DOI
[14]Fujimoto E Sumen Y Urabe Y An early return to vigorous activity may destabilize anterior cruciate ligaments reconstructed with hamstring grafts Arch Phys Med Rehabil 2004 85 298 302 10.1016/S0003-9993(03)00621-X 14966717 · DOI
[15]Gohil S, Annear PO, Breidahl W (2007) Anterior cruciate ligament reconstruction using autologous double hamstrings: a comparison of standard versus minimal debridement techniques using MRI to assess revascularization. J Bone J Surg 89-B:1165–1171 17905952
[16]Goradia VK Rochat MC Grana WA Tendon-to-bone healing of a semitendinosus tendon autograft used for ACL reconstruction in a sheep model Am J Knee Surg 2000 13 143 151 11277242
[17]Grana WA Egle DM Mahnken R An analysis of autograft fixation after anterior cruciate ligament reconstruction in a rabbit model Am J Sports Med 1994 22 344 351 10.1177/036354659402200309 8037275 · DOI
[18]Howell SM Knox KE Farley TE Revascularization of a human anterior cruciate ligament graft during the first two years of implantation Am J Sports Med 1995 23 42 49 10.1177/036354659502300107 7726349 · DOI
[19]Howell SM, Taylor MA (1996) Brace–free rehabilitation, with early return to activity, for knees reconstructed with a double-looped semitendinosus and gracilis graft. J Bone Joint Surg 78-A:814–825 8666598
[20]Jackson DW, Grood ES, Cohn BT et al (1991) The effects of in situ freezing on the anterior cruciate ligament. An experimental study in goats. J Bone Joint Surg 73-A:201–213 1993715
[21]Jackson DW Grood ES Goldstein JD A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model Am J Sports Med 1993 21 176 185 10.1177/036354659302100203 8465909 · DOI
[22]Jackson JR Minton JA Ho ML Expression of vascular endothelial growth factor in synovial fibroblasts is induced by hypoxia and interleukin 1beta J Rheumatol 1997 24 1253 1259 9228120
[23]Janssen RP Du Mée AW Valkenburg VJ Anterior cruciate ligament reconstruction with hamstring tendons and accelerated rehabilitation: a 10-year prospective study on clinical results, knee osteoarthritis and its predictors Knee Surg Sports Traumatol Arthrosc 2012 23081710
[24]Janssen RP van der Wijk J Fiedler A Remodelling of human hamstring autografts after anterior cruciate ligament reconstruction Knee Surg Sports Traumatol Arthrosc 2011 19 1299 1306 10.1007/s00167-011-1419-y 21293848 PMC3136699 · DOI · Paper page
[25]Johnson LL The outcome of a free autogenous semitendinosus tendon graft in human anterior cruciate reconstructive surgery: a histological study Arthroscopy 1993 9 131 142 10.1016/S0749-8063(05)80362-7 8461069 · DOI · Paper page
[26]Kawamura S Ying L Kim HJ Macrophages accumulate in the early phase of tendon-bone healing J Orthop Res 2005 23 1425 1432 10.1016/j.orthres.2005.01.014 16111854 · DOI · Paper page
[27]Kleiner JB Amiel D Harwood FL Early histological, metabolic, and vascular assessment of anterior cruciate ligament autografts J Orthop Res 1989 7 235 242 10.1002/jor.1100070211 2918422 · DOI
[28]Kleiner JB Amiel D Roux RD Origin of replacement cells for the anterior cruciate ligament autograft J Orthop Res 1986 4 466 474 10.1002/jor.1100040410 2946835 · DOI
[29]Kuroda R Kurosaka M Yoshiya S Localization of growth factors in the reconstructed anterior cruciate ligament: immunohistological study in dogs Knee Surg Sports Traumatol Arthrosc 2000 8 120 126 10.1007/s001670050198 10795676 · DOI
[30]Lane JG McFadden P Bowden K The ligamentization process: a 4 year case study following ACL reconstruction with a semitendinosis graft Arthroscopy 1993 9 149 153 10.1016/S0749-8063(05)80364-0 8461071 · DOI
[31]Liu SH Yang RS Al-Shaikh R Collagen in tendon, ligament, and bone healing. A current review Clin Orthop Relat Res 1995 318 265 278 7671527
[32]McFarland EG The biology of anterior cruciate ligament reconstructions Orthopedics 1993 16 403 410 8493146
[33]Marumo K Saito M Yamagishi T The “ligamentization” process in human anterior cruciate ligament reconstruction with autogenous patellar and hamstring tendons Am J Sports Med 2005 33 1166 1173 10.1177/0363546504271973 16000668 · DOI
[34]Mayr HO Stoehr A Dietrich M Graft-dependent differences in the ligamentization process of anterior cruciate ligament grafts in a sheep trial Knee Surg Sports Traumatol Arthrosc 2012 20 947 956 10.1007/s00167-011-1678-7 21953379 · DOI
[35]Ménétrey J Duthon VB Laumonier T “Biological failure” of the anterior cruciate ligament graft Knee Surg Sports Traumatol Arthrosc 2008 16 224 231 10.1007/s00167-007-0474-x 18183368 · DOI · Paper page
[37]Ng GY Oakes BW Deacon OW Biomechanics of patellar tendon autograft for reconstruction of the anterior cruciate ligament in the goat: three-year study J Orthop Res 1995 13 602 608 10.1002/jor.1100130416 7674076 · DOI
[38]Ng GY Oakes BW Deacon OW Long-term study of the biochemistry and biomechanics of anterior cruciate ligament-patellar tendon autografts in goats J Orthop Res 1996 14 851 856 10.1002/jor.1100140602 8982125 · DOI
[39]Ohno K Yasuda K Yamamoto N Effects of complete stress-shielding on the mechanical properties and histology of in situ frozen patellar tendon J Orthop Res 1993 11 592 602 10.1002/jor.1100110414 8340831 · DOI
[40]Papageorgiou CD Ma CB Abramowitch SD A multidisciplinary study of the healing of an intra-articular anterior cruciate ligament graft in a goat model Am J Sports Med 2001 29 620 626 11573921
[41]Papalia R Franceschi F Vasta S Sparing the anterior cruciate ligament remnant: is it worth the hassle? Br Med Bull 2012 104 91 111 10.1093/bmb/ldr053 22257853 · DOI
[42]Petersen W Wildemann B Pufe T The angiogenic peptide pleiotrophin (PTN/HB-GAM) is expressed in fracture healing: an immunohistochemical study in rats Arch Orthop Trauma Surg 2003 124 603 607 10.1007/s00402-003-0582-0 14586627 · DOI
[43]Rougraff BT Shelbourne KD Early histologic appearance of human patellar tendon autografts used for anterior cruciate ligament reconstruction Knee Surg Sports Traumatol Arthrosc 1999 7 9 14 10.1007/s001670050113 10024956 · DOI · Paper page
[44]Sanchez M Anitua E Azofra J Ligamentization of tendon grafts treated with an endogenous preparation rich in growth factors: gross morphology and histology Arthroscopy 2010 26 470 480 10.1016/j.arthro.2009.08.019 20362825 · DOI · Paper page
[45]Scheffler SU Scherler J Pruss A Biomechanical comparison of human bone-patellar tendon-bone grafts after sterilization with peracetic acid ethanol Cell Tissue Bank 2005 6 109 115 10.1007/s10561-004-6403-z 15909098 · DOI
[46]Scheffler SU Unterhauser FN Weiler A Graft remodeling and ligamentization after cruciate ligament reconstruction Knee Surg Sports Traumatol Arthrosc 2008 16 834 842 10.1007/s00167-008-0560-8 18516592 · DOI · Paper page
[47]Scranton PE Jr Lanzer WL Ferguson MS Mechanisms of anterior cruciate ligament neovascularization and ligamentization Arthroscopy 1998 14 702 716 10.1016/S0749-8063(98)70097-0 9788366 · DOI
[48]Seitz H Menth-Chiari WA Lang S Histological evaluation of the healing potential of the anterior cruciate ligament by means of augmented and non-augmented repair: an in vivo animal study Knee Surg Sports Traumatol Arthrosc 2008 16 1087 1093 10.1007/s00167-008-0599-6 18712354 · DOI
[49]Shelbourne KD Nitz P Accelerated rehabilitation after anterior cruciate ligament reconstruction Am J Sports Med 1990 18 292 299 10.1177/036354659001800313 2372081 · DOI
[50]Shino K Horibe S Experimental ligament reconstruction by allogeneic tendon graft in a canine model Acta Orthop Belg 1991 57 Suppl 2 44 53 1792884
[51]Shino K, Kawasaki T, Hirose H et al (1984) Replacement of the anterior cruciate ligament by an allogeneic tendon graft. An experimental study in the dog. J Bone Joint Surg 66-B:672–681 6501359
[52]Spindler KP Andrish JT Miller RR Distribution of cellular repopulation and collagen synthesis in a canine anterior cruciate ligament autograft J Orthop Res 1996 14 384 389 10.1002/jor.1100140307 8676250 · DOI · Paper page
[53]Stener S Ejerhed L Movin T The reharvested patellar tendon has the potential for ligamentization when used for anterior cruciate ligament revision surgery Knee Surg Sports Traumatol Arthrosc 2012 20 1168 1174 10.1007/s00167-012-1908-7 22310901 · DOI
[54]Tohyama H, Yasuda K (2002) The effect of increased stress on the patellar tendon. J Bone Joint Surg 84-B:440–446 12002508
[55]Unterhauser FN Bail HJ Höher J Endoligamentous revascularization of an anterior cruciate ligament graft Clin Orthop Relat Res 2003 414 276 288 10.1097/01.blo.0000079442.64912.51 12966303 · DOI · Paper page
[56]Unterhauser FN Bosch U Zeichen J Alpha-smooth muscle actin containing contractile fibroblastic cells in human knee arthrofibrosis tissue. Winner of the AGA-DonJoy Award 2003 Arch Orthop Trauma Surg 2004 124 585 591 10.1007/s00402-004-0742-x 15378321 · DOI
[57]Vogrin M Rupreht M Dinevski D Effects of a platelet gel on early graft revascularization after anterior cruciate ligament reconstruction: a prospective randomized, double-blind, clinical trial Eur Surg Res 2010 45 77 85 10.1159/000318597 20814217 · DOI
[58]Weiler A Förster C Hunt P The influence of locally applied platelet-derived growth factor-BB on free tendon graft remodeling after anterior cruciate ligament reconstruction Am J Sports Med 2004 32 881 891 10.1177/0363546503261711 15150033 · DOI · Paper page
[59]Weiler A Hoffmann RF Bail HJ Tendon healing in a bone tunnel. Part II: histological analysis after biodegradable interference fit fixation in a model of anterior cruciate ligament reconstruction in sheep Arthroscopy 2002 18 124 135 10.1053/jars.2002.30657 11830805 · DOI
[60]Weiler A Peine R Pahminez-Azar A Tendon healing in a bone tunnel. Part I: biomechanical results after biodegradable interference fit fixation in a model of anterior cruciate ligament reconstruction in sheep Arthroscopy 2002 18 113 123 10.1053/jars.2002.30656 11830804 · DOI
[61]Weiler A Peters G Mäurer J Biomechanical properties and vascularity of an anterior cruciate ligament graft can be predicted by contrast-enhanced magnetic resonance imaging. A two-year study in sheep Am J Sports Med 2001 29 751 761 11734489
[62]Weiler A Unterhauser FN Bail HJ Alpha-smooth muscle actin is expressed by fibroblastic cells of the ovine anterior cruciate ligament and its free tendon graft during remodeling J Orthop Res 2002 20 310 317 10.1016/S0736-0266(01)00109-7 11918311 · DOI
[63]Xu Y Ao Y Histological and biomechanical studies of inter-strand healing in four-strand autograft anterior cruciate ligament reconstruction in a rabbit model Knee Surg Sports Traumatol Arthrosc 2009 17 770 777 10.1007/s00167-009-0764-6 19305977 · DOI
[64]Yoshikawa T Tohyama H Katsura T Effects of local administration of vascular endothelial growth factor on mechanical characteristics of the semitendinosus tendon graft after anterior cruciate ligament reconstruction in sheep Am J Sports Med 2006 34 1918 1925 10.1177/0363546506294469 17092923 · DOI
[65]Zaffagnini S De Pasquale V Marchesini Reggiani L Neoligamentization process of BTPB used for ACL graft: histological evaluation from 6 months to 10 years Knee 2007 14 87 93 10.1016/j.knee.2006.11.006 17188877 · DOI
[66]Zaffagnini S De Pasquale V Marchesini Reggiani L Electron microscopy of the remodelling process in hamstring tendon used as ACL graft Knee Surg Sports Traumatol Arthrosc 2010 18 1052105 1052108 19787336

Sorted by citations

Synovitis following anterior cruciate ligament reconstruction using the LARS device
Tulloch, S. J., Devitt, B. M., Norsworthy, C. J., & Mow, C. (2019) · Knee Surgery, Sports Traumatology, Arthroscopy · doi:10.1007/s00167-018-5280-0 · Cited by 41 · see citing works
Allograft Donor Characteristics Significantly Influence Graft Rupture After Anterior Cruciate Ligament Reconstruction in a Young Active Population
Shumborski, S., Salmon, L. J., Monk, C., Heath, E., Roe, J. P., & Pinczewski, L. A. (2020) · The American Journal of Sports Medicine · doi:10.1177/0363546520938777 · Cited by 25 · see citing works
Bone Mesenchymal Stem Cells Contribute to Ligament Regeneration and Graft–Bone Healing after Anterior Cruciate Ligament Reconstruction with Silk–Collagen Scaffold
Bi, F., Chen, Y., Liu, J., Hu, W., & Tian, K. (2021) · Stem Cells International · doi:10.1155/2021/6697969 · Cited by 18 · see citing works
“However, in the early postoperative period, limited ingrowth of the newly regenerated connective tissue in the knee cavity restricted ligament regeneration, and bone tissue in the bone tunnel disrupted graft–bone healing [13, 14].”
Background
Comparison of ligamentization potential between anterior cruciate ligament-derived cells and adipose-derived mesenchymal stem cells reseeded to acellularized tendon allograft
Park, J., Jo, S., Lee, M.-K., Kim, T.-H., Sung, I.-H., & Lee, J. K. (2022) · Bone & Joint Research · doi:10.1302/2046-3758.1111.bjr-2021-0548.r2 · Cited by 12 · see citing works
A new biological enhancement therapy for anterior cruciate ligament reconstruction: the preclinical proof of anterior cruciate ligament reconstruction with tendon graft reseeded with autologous anterior cruciate ligament-derived cells
Park, J., Soh, H., Jang, Y.-K., Lee, Y. S., Lee, M.-K., Kim, H., Kim, T.-H., Alkhelaifi, K., Kim, T.-J., & Lee, J. K. (2025) · Stem Cell Research & Therapy · doi:10.1186/s13287-025-04760-1 · Cited by 3 · see citing works

Authors: Janssen, R. P. A., & Scheffler, S. U.
Affiliations: Máxima Medisch Centrum (NL)
Chirurgisch Orthopädischer PraxisVerbund (COPV) Breitenbachplatz 8 14195 Berlin Germany
Corresponding author: Janssen, Rob P. A.
ORCID: Janssen, Rob P. A.
Scheffler, Sven U.
Venue: Knee Surgery, Sports Traumatology, Arthroscopy
Publisher: Wiley
Published: 2013-08-27
Volume: 22
Issue: 9
Pages: 2102-2108
ISSN: 0942-2056 (ISSN-L)
1433-7347
DOI: 10.1007/s00167-013-2634-5
PMC: PMC4142140
OpenAlex: W2023416936
Cited by: 225
References: 2
Citations by year: 2026: 14 · 2025: 20 · 2024: 18 · 2023: 23 · 2022: 23 · 2021: 26 · 2020: 22 · 2019: 19 · 2018: 13 · 2017: 14 · 2016: 19 · 2015: 8 · 2014: 6
FWCI: 1.95
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Knee Surgery Sports Traumatology Arthroscopy (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
Keywords: anterior cruciate ligament reconstruction, hamstring tendon graft, graft necrosis, graft revascularization, ligamentization, postoperative rehabilitation, graft mechanical properties
MeSH terms: Anterior Cruciate Ligament Injuries, Animals, Humans, Knee Joint, Tendons, Wound Healing, Anterior Cruciate Ligament, Transplants, Anterior Cruciate Ligament Reconstruction

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Intra‐articular remodelling of hamstring tendon grafts after anterior cruciate ligament reconstruction

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Record

About these checks