Observation of 2D-magnesium-intercalated gallium nitride superlattices.

Since the demonstration of p-type gallium nitride (GaN) through doping with substitutional magnesium (Mg) atoms1,2, rapid and comprehensive developments, such as blue light-emitting diodes, have considerably shaped our modern lives and contributed to a more carbon-neutral society3-5. However, the details of the interplay between GaN and Mg have remained largely unknown6-11. Here we observe that Mg-intercalated GaN superlattices can form spontaneously by annealing a metallic Mg film on GaN at atmospheric pressure. To our knowledge, this marks the first instance of a two-dimensional metal intercalated into a bulk semiconductor, with each Mg monolayer being intricately inserted between several monolayers of hexagonal GaN. Characterized as an interstitial intercalation, this process induces substantial uniaxial compressive strain perpendicular to the interstitial layers. Consequently, the GaN layers in the Mg-intercalated GaN superlattices exhibit an exceptional elastic strain exceeding -10% (equivalent to a stress of more than 20 GPa), among the highest recorded for thin-film materials12. The strain alters the electronic band structure and greatly enhances hole transport along the compression direction. Furthermore, the Mg sheets induce a unique periodic transition in GaN polarity, generating polarization-field-induced net charges. These characteristics offer fresh insights into semiconductor doping and conductivity enhancement, as well as into elastic strain engineering of nanomaterials and metal-semiconductor superlattices13.

Multiplexing of bias-controlled modulation modes on a monolithic III-nitride optoelectronic chip.

III-nitride optoelectronic chips have tremendous potential for developing integrated computing and communication systems with low power consumption. The monolithic, top-down approaches are advantageous for simplifying the fabrication process and reducing the corresponding manufacturing cost. Herein, an ultraviolet optical interconnection system is investigated to discover the way of multiplexing between emission and absorption modulations on a monolithic optoelectronic chip. All on-chip components, the transmitter, monitor, waveguide, modulator, and receiver, share the same quantum well structure. As an example, two bias-controlled modulation modes are used to modulate video and audio signals in the experiment presented in this Letter. The results show that our on-chip optoelectronic system works efficiently in the near ultraviolet band, revealing the potential breadth of GaN optoelectronic integration.

Changes in patellar height after anatomical ACL reconstruction with BTB autograft with a focus on patellar tendon removal volume.

BACKGROUND: Although anatomical anterior cruciate ligament reconstruction (ACLR) can provide satisfactory outcomes, little is known about how this procedure impacts patellar height. Since harvesting bone-patellar tendon-bone (BTB) autografts is a potential risk factor for decreased patellar height, we examined changes in patellar height after anatomical ACLR with BTB autograft with a focus on the size of the harvested graft. METHODS: Subjects were 84 patients (49 males, 35 females; mean age, 23 years) who underwent primary anatomical ACLR with central third BTB autograft. Preoperative to postoperative Caton-Deschamps index (CDI) ratio was calculated using lateral knee radiographs before and 6 months after surgery. The length and cross-sectional area (CSA) of the graft were measured intraoperatively, and the CSA of the contralateral patellar tendon was measured by ultrasound 6 months postoperatively. The difference in graft CSA relative to the contralateral tendon CSA, expressed as a percentage (gCSA:ctCSA percentage), was also calculated. RESULTS: Patellar height decreased slightly after surgery (preoperative CDI: 0.856 ± 0.113; postoperative CDI: 0.841 ± 0.113), with a mean difference between preoperative and postoperative CDIs of -0.015 (range: -0.293 to 0.101). Although the CDI of male subjects significantly decreased after surgery (preoperative: 0.852 ± 0.117; postoperative: 0.827 ± 0.115), no significant changes were noted in female subjects (preoperative: 0.862 ± 0.108; postoperative: 0.861 ± 0.108). Graft length and CSA did not significantly impact the CDI ratio (r = -0.138 and r = -0.038, respectively). Moreover, no significant relationship was observed between the gCSA:ctCSA percentage and CDI ratio (r = 0.118). CONCLUSIONS: Although patellar height slightly, but significantly, decreased at 6 months after anatomical ACLR with BTB autograft, it was not affected by the length and CSA of harvested grafts. The decrease in postoperative patellar height was observed only in male subjects, suggesting the potential importance of sex differences in soft tissue healing during the postoperative period.

Rectangular bone-patellar tendon bone grafts reduce early graft failure in chronic ACL-Deficient knees.

BACKGROUND: The aim of this study was to assess early graft failure after anterior cruciate ligament (ACL) reconstruction according to chronicity of ACL deficiency (ACLD) and clarify predisposing factors. METHODS: A total of 731 patients who underwent anatomic ACL reconstruction were divided into 3 groups based on chronicity of ACLD: <6 months (Group 1), 6 months to 2 years (Group 2), and >2 years (Group 3). Types of ACL grafts used included single-bundle hamstring tendon (HT), multiple-bundle HT, and rectangular bone-patellar tendon-bone (BTB) grafts. Preoperatively and immediately postoperatively, lateral radiographs in full extension were taken to examine anterior tibial subluxation (ATS). All ACL grafts were evaluated by MRI at 6 months to identify graft failure. The group with the highest failure rate was further examined to compare possible risk factors between the intact and failure subgroups, followed by multivariate logistic regression analysis to identify predisposing factors. RESULTS: Early graft failure on MRI without any episode of postoperative trauma was observed in 7 (1.4%), 2 (1.8%), and 11 (9.2%) patients in Groups 1, 2, and 3, respectively, with a significantly higher rate in Group 3 (P < 0.001). Of the 119 patients in Group 3, significant differences were observed between intact and failure subgroups with regard to surgical procedure (P = 0.03), chondral lesions (P < 0.01), and preoperative ATS (P < 0.01). Multivariate logistic regression analysis revealed that surgical procedures (odds ratio, 3.8; 95%CI, 1.16-12.59) and preoperative ATS (odd ratio, 2.4; 95%CI, 1.26-4.38) were predisposing factors of early graft failure. CONCLUSION: Patients with ACLD for >2 years experienced early graft failure with an incidence rate of 9.2%. Predisposing factors of early graft failure in these patients included the use of single-bundle HT grafts and preoperative ATS. The use of rectangular BTB grafts resulted in a lower graft failure rate. STUDY DESIGN: Case Series.

[Asymptomatic Ball Thrombus in Right Atrium Under Anticoagulant Therapy:Report of a Case].

A rare case of isolated right atrial thrombus under anticoagulant therapy for atrial fibrillation is reported herein. The patient was an 81-year-old man undergoing anticoagulant therapy with oral warfarin for atrial fibrillation. During preoperative screening for eye surgery, echocardiography revealed a mobile mass in the right atrium, and emergency hospital admission was indicated. Excision of the right atrial thrombus was performed, and no residual thrombus was detected on postoperative imaging studies. This case was considered a good indication for surgical resection because of potential risk of fatal embolism.

Interplay of sidewall damage and light extraction efficiency of micro-LEDs.

This Letter describes the impact of shape on micro light-emitting diodes (µLEDs), analyzing 400 µm2 area µLEDs with various mesa shapes (circular, square, and stripes). Appropriate external quantum efficiency (EQE) can yield internal quantum efficiency (IQE) which decreases with increasing peripheral length of the mesas. However, light extraction efficiency (ηe) increased with increasing mesa periphery. We introduce analysis of Jpeak (the current at peak EQE) since it is proportional to the non-radiative recombination. Etching the sidewalls using tetramethylammonium hydroxide (TMAH) increased the peak EQE and decreased the sidewall dependency of Jpeak. Quantitatively, the TMAH etching reduced non-radiative surface recombination by a factor of four. Hence, shrinking µLEDs needs an understanding of the relationship between non-radiative recombination and ηe, where analyzing Jpeak can offer new insights.

[A Giant Right Coronary Artery Aneurysm:Report of a Case].

We report the case of a 49-year-old woman with a giant atherosclerotic thrombus-filled aneurysm of the right coronary artery. She was referred to our hospital because of abnormal finding of the chest X-ray. Echocardiography revealed a large cystic mass adjacent to the right atrium and computed tomography revealed a giant aneurysm of middle segment of the right coronary artery. Based on the size of the aneurysm, the patient underwent exclusion of the aneurysm by proximal and distal ligation and coronary artery bypass surgery. Giant coronary artery aneurysm is rare, and the management should be individualized depending on size, location, and clinical context.

Reconstruction of a three-dimensional color-video of a point-cloud object using the projection-type holographic display with a holographic optical element.

Here, we managed to reconstruct a three-dimensional color video of a point-cloud object using a projection-type holographic display with a holographic optical element as an optical screen. The holographic optical element has the function of an off-axis concave mirror and has been created by the wavefront printer digitally. We defined and implemented an algorithm to reconstruct a three-dimensional image at a chosen position considering the specification of the holographic optical element designed digitally. We successfully demonstrated a reconstruction of the color video in question, composed of three-dimensional images through the holographic optical element.

Importance of functional performance and psychological readiness for return to preinjury level of sports 1 year after ACL reconstruction in competitive athletes.

PURPOSE: This study aimed to identify independent predictive factors for return to sports (RTS) after anterior cruciate ligament (ACL) reconstruction in competitive-level athletes and to determine optimal cut-off values for these factors at 6 months after surgery. METHODS: A total of 124 competitive athletes (50 males and 74 females; mean age, 17.0 years; preinjury Tegner activity scale > 7) who underwent primary ACL reconstruction were enrolled. Assessments at 6 months after surgery consisted of knee functional tests [quadriceps index, hamstrings index, and single-leg hop for distance (SLH)] and 2 self-report questionnaires [IKDC subjective score and ACL-Return to Sport after Injury scale (ACL-RSI)]. At 1 year after surgery, athletes were classified into the RTS group (n = 101) or non-RTS group (n = 23) based on self-reported sports activities. After screening possible predictive factors of RTS, multivariate logistic regression and receiver operating characteristic curve analyses were performed to identify independent factors. RESULTS: Multivariate logistic regression analysis identified SLH (odds ratio, 2.861 per 10 unit increase; P < 0.001) and ACL-RSI (odds ratio, 1.810 per 10 unit increase; P = 0.001) at 6 months as independent predictors of RTS at 1 year after surgery. Optimal cut-off values of SLH and ACL-RSI were 81.3% (sensitivity = 0.891; specificity = 0.609) and 55 points (sensitivity = 0.693; specificity = 0.826), respectively. CONCLUSION: In competitive athletes, SLH < 81% and ACL-RSI < 55 points at 6 months after surgery were associated with a greater risk of unsuccessful RTS at 1 year after surgery. SLH and ACL-RSI at 6 months could serve as screening tools to identify athletes who have difficulties with returning to sports after ACL reconstruction. LEVEL OF EVIDENCE: III.

Compositional control of homogeneous InGaN nanowires with the In content up to 90.

Homogenous InGaN nanowires with a controlled indium composition up to 90% are grown on GaN/c-Al2O3 templates by catalyst-free hydride vapor phase epitaxy using InCl3 and GaCl as group III element precursors. The influence of the partial pressures on the growth rate and composition of InGaN nanowires is investigated. It is shown how the InN mole fraction in nanowires can be finely tuned by changing the vapor phase composition. Thermodynamic calculations are presented that take into account different interconnected reactions in the vapor phase and show a good agreement with the compositional data. Energy dispersive x-ray spectroscopy profiles performed on single nanowires show a homogenous indium composition along the entire nanowire length. X-ray diffraction measurements performed on nanowires arrays confirm these data. High-resolution transmission electron microscopy analysis shows the wurtzite crystal structure with a reduced defect density for InGaN nanowires with the highest indium content.

Significant anterior enlargement of femoral tunnel aperture after hamstring ACL reconstruction, compared to bone-patellar tendon-bone graft.

PURPOSE: This study aimed to retrospectively compare the enlargement and migration of the femoral tunnel aperture after anatomic rectangular tunnel anterior cruciate ligament (ACL) reconstruction with a bone-patella tendon-bone (BTB) or hamstring tendon (HT) graft using three-dimensional (3-D) computer models. METHODS: Thirty-two patients who underwent ACL reconstruction and postoperative computed tomography (CT) at 3 weeks and 6 months were included in this study. Of these, 20 patients underwent ACL reconstruction with a BTB graft (BTBR group), and the remaining 12 with an HT graft (HTR group). The area of the femoral tunnel aperture was extracted and measured using a 3-D computer model generated from CT images. Changes in the area and migration direction of the femoral tunnel aperture during this period were compared between the two groups. RESULTS: In the HTR group, the area of the femoral tunnel aperture was significantly increased at 6 months compared to 3 weeks postoperatively (P < 0.05). The average area of the femoral tunnel aperture at 6 months postoperatively was larger by 16.0 ± 12.4% in the BTBR group and 41.9 ± 22.2% in the HTR group, relative to that measured at 3 weeks postoperatively (P < 0.05). The femoral tunnel aperture migrated in the anteroinferior direction in the HTR group, and only in the inferior direction in the BTBR group. CONCLUSIONS: The femoral tunnel aperture in the HTR group was significantly more enlarged and more anteriorly located at 6 months after ACL reconstruction, compared to the BTBR group. LEVEL OF EVIDENCE: IV.

Relationship between bone plug position and morphological changes of tunnel aperture in anatomic rectangular tunnel ACL reconstruction.

PURPOSE: In animal studies after ACL reconstruction (ACL-R) using the bone-patellar tendon-bone (BTB), the graft-healing pattern was found to depend on the relationship between bone plug and the tunnel wall. This difference of graft-healing pattern could influence the postoperative morphological changes of the tunnel. However, no study has assessed the relationship between bone plug position and the change of tunnel morphology. Therefore, the main purpose of this study was to investigate the relationship between the bone plug position within femoral or tibial tunnel and morphological changes of each tunnel aperture in ACL-R using computed tomography. METHODS: Subjects were 30 consecutive patients (six females and 24 males; mean age, 20.4 ± 5.4 years) who underwent primary ACL-R using BTB. The distance from the tunnel aperture to the tendon-bone junction (TBJ) at 2 weeks postoperatively, and tunnel aperture enlargement and tunnel wall migration from 2 weeks to 6 months postoperatively, were evaluated. RESULTS: The distance from the femoral tunnel aperture to the TBJ in most cases was less than 2 mm, whereas the TBJ was located within the tibial tunnel. Femoral tunnel aperture was significantly enlarged (17.0 ± 11.7%) distally, and the tibial tunnel aperture was significantly enlarged (19.6 ± 12.5%) posterolaterally. Only the position at distal portion of femoral bone plug was correlated with femoral tunnel aperture enlargement (r = 0.454, p = 0.0015). CONCLUSION: Both femoral and tibial tunnel aperture were significantly enlarged distally and posterolaterally 6 months postoperatively. Only correlation between the position at distal portion of femoral bone plug and femoral tunnel enlargement were found, suggesting the deep plug position in the tunnel is a risk factor for femoral tunnel enlargement, highlighting the importance of accurately locating the TBJ just at the femoral tunnel aperture. Another option is to deviate the harvest site in the patellar tendon to match the shape of the TBJ and the tunnel aperture. LEVEL OF EVIDENCE: 4 (case series).

Low Voltage High-Energy α-Particle Detectors by GaN-on-GaN Schottky Diodes with Record-High Charge Collection Efficiency.

A low voltage (-20 V) operating high-energy (5.48 MeV) α-particle detector with a high charge collection efficiency (CCE) of approximately 65% was observed from the compensated (7.7 × 1014 /cm3) metalorganic vapor phase epitaxy (MOVPE) grown 15 µm thick drift layer gallium nitride (GaN) Schottky diodes on free-standing n+-GaN substrate. The observed CCE was 30% higher than the bulk GaN (400 µm)-based Schottky barrier diodes (SBD) at -20 V. This is the first report of α-particle detection at 5.48 MeV with a high CCE at -20 V operation. In addition, the detectors also exhibited a three-times smaller variation in CCE (0.12 %/V) with a change in bias conditions from -120 V to -20 V. The dramatic reduction in CCE variation with voltage and improved CCE was a result of the reduced charge carrier density (CCD) due to the compensation by Mg in the grown drift layer (DL), which resulted in the increased depletion width (DW) of the fabricated GaN SBDs. The SBDs also reached a CCE of approximately 96.7% at -300 V.

Light output performance of red AlGaInP-based light emitting diodes with different chip geometries and structures.

We investigated the optical and electrical properties of red AlGaInP light-emitting diodes (LEDs) as functions of chip size, p-cladding layer thickness, and the number of multi-quantum wells (MQWs). External quantum efficiency (EQE) decreased with decreasing chip size. The ideality factor gradually increased from 1.47 to 1.95 as the chip size decreased from 350 µm to 15 µm. This indicates that the smaller LEDs experienced larger carrier loss due to Shockley-Read-Hall nonradiative recombination at sidewall defects. S parameter, defined as ∂lnL/∂lnI, increased with decreasing chip size. Simulations and experimental results showed that smaller LEDs with 5 pairs of MQWs had over 30% higher IQE at 5 A/cm2 than the LED with 20 pairs of MQWs. These results show that the optimization of the number of QWs is needed to obtain maximum EQE of micro-LEDs.

Sex Differences in the Residual Patellar Tendon After Harvesting Its Central Third for Anterior Cruciate Ligament Reconstruction.

OBJECTIVES: Some studies have found that sex can affect the clinical results after anterior cruciate ligament reconstruction. We hypothesized that sex would significantly affect the healing of the postoperative patellar tendon. This study evaluated the patellar tendon after bone-patellar tendon-bone autograft harvest, specifically with regard to sex-dependent differences. METHODS: At 6 months postoperatively, an ultrasonographic evaluation was performed. We measured the residual donor site gap width between tendon tissues and the thickness of newly formed nontendinous tissue in the gap. In addition, the cross-sectional area of tendon tissue was measured. The ratios between the operated and contralateral sides were calculated, and the sexes were compared. A paired Student t test was performed, with P < .05 considered statistically significant. RESULTS: The population of 52 patients (32 male and 20 female) had a mean age ± SD of 23 ± 8 years. We observed no significant sex-dependent differences in the residual donor site gap and the thickness of newly formed nontendinous tissue when calculating ratios to the contralateral tendon. The mean cross-sectional area of tendon tissue was 101 ± 26 mm2 (male, 114 ± 26 mm2 ; female, 80 ± 16 mm2 ). When the ratios to the contralateral tendon were calculated, male patients had significantly higher cross-sectional area ratios than female patients (male, 124% ± 20%; female, 100% ± 19%, P = .024). CONCLUSIONS: We have reported a dramatic increase in the cross-sectional area of patellar tendon tissue during the first 6 months after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone autograft, which was more prominent in male patients than in female patients. This difference might have contributed to the sex-dependent variation in clinical outcomes.

Femoral tunnel enlargement after anatomic anterior cruciate ligament reconstruction: Bone-patellar tendon-bone /single rectangular tunnel versus hamstring tendon / double tunnels.

PURPOSE: This study aimed to prospectively compare the femoral tunnel enlargement at the aperture as well as inside the tunnel after anatomic anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BTB) graft to that with hamstring tendon (HST) graft. METHODS: This study included 24 patients with unilateral ACL rupture. Twelve patients underwent anatomic rectangular tunnel (ART) ACL reconstruction with BTB graft and the remaining 12 underwent anatomic triple-bundle (ATB) ACL reconstruction with HST graft. Three-dimensional computer models of femur and bone tunnels were reconstructed from computed tomography images obtained at 3 weeks and 1 year postoperatively. The femoral tunnel enlargement from 3 weeks to 1 year was evaluated by comparing the cross-sectional area (CSA), and compared between the two groups. RESULTS: The CSA in the ART group at 1 year decreased at the aperture as well as inside the tunnel comparing that at 3 weeks. The CSAs of both tunnels in the ATB group at 1 year significantly increased at the aperture in comparison to those at 3 weeks, and gradually decreased toward the inside of the tunnel. The enlargement rate at the aperture in the ART group was -12.9%, which was significantly smaller than that of anteromedial graft (27.9%; P = 0.006) and posterolateral graft (31.3%; P = 0.003) in the ATB group. The tunnel enlargement rate at 5 mm from the aperture in the ART group was also significantly smaller than that in the ATB group. At 10 mm from the aperture, there was no significant difference between the tunnel enlargement rate in the ART group and that of anteromedial tunnel. CONCLUSIONS: The tunnel enlargement rate around the aperture was significantly smaller after the ART procedure than that after the ATB procedure. Thus, BTB graft might be preferable as a graft material to HST graft in the femoral tunnel enlargement.

Second look arthroscopic evaluation of repaired radial/oblique tears of the midbody of the lateral meniscus in stable knees.

BACKGROUND: Radial/oblique tears of the midbody of the lateral meniscus significantly impair the ability of the meniscus to withstand the tibiofemoral load, requiring meniscal repair. However, healing status after meniscal repair has not been fully elucidated. This study aimed to evaluate arthroscopic findings after inside-out suture repair for isolated radial/oblique tears of the midbody of the lateral meniscus. METHODS: From 2011 to 2015, 18 consecutive patients with isolated radial/oblique tears of the midbody of the lateral meniscus underwent arthroscopic inside-out repair with the tie-grip suture technique. All knees were stable with no previous surgery. All patients were evaluated by second-look arthroscopy at six months postoperatively. Activities including jogging were not allowed until meniscal status was evaluated arthroscopically. To analyze factors associated with healing rates, age, time from injury to initial surgery, and tear zone were compared. RESULTS: Second-look arthroscopy revealed complete healing in four (22%) patients, partial healing in seven (39%), and failure to heal in seven (39%). Significant differences were observed for tear zone (p < 0.0001), but not for age and timing of repair. CONCLUSIONS: Arthroscopic evaluation revealed that inside-out repair with the tie-grip suture technique for isolated radial/oblique tears of the midbody of the lateral meniscus achieved complete or partial healing only in 61% of patients. Satisfactory results were observed particularly in patients with tears extending to the vascular zone, whereas those with tears in the avascular zone failed to achieve healing. Therefore, the operative indication of inside-out repair for radial/oblique tears of the midbody of the lateral meniscus might be limited to tears extending into the vascular zone. Given that 39% of cases were arthroscopically considered a failure even if patients complained of no symptoms in daily life, decisions should be made carefully to allow patients to return to sports activities.

The use of the cannibalistic habit and elevated relative humidity to improve the storage and shipment of the predatory mite Neoseiulus californicus (Acari: Phytoseiidae).

This study investigated the feasibility of using the cannibalistic habits of the mite Neoseiulus californicus (McGregor) and controlling the relative humidity (RH) to prolong the survival time during the storage or shipment of this predatory mite. Three-day-old mated and unmated females were individually kept at 25 ± 1 °C in polypropylene vials (1.5 mL), each containing one of the following items or combinations of items: a kidney bean leaf disk (L), N. californicus eggs (E), and both a leaf disk and the eggs (LE). Because the leaf disk increased the RH in the vials, the RH was 95 ± 2 % under the L and LE treatments and 56 ± 6 % under the E treatment. The median lethal time (LT50) exceeded 50 days for the mated and unmated females under the LE treatment. However, it did not exceed 11 or 3 days for all females under the L or E treatments, respectively. Under the LE treatment, the mated and unmated females showed cannibalistic behavior and consumed an average of 5.2 and 4.6 eggs/female/10 days. Some of the females that survived for LT50 under each treatment were transferred and fed normally with a constant supply of Tetranychus urticae Koch. Unmated females were provided with adult males for 24 h for mating. Only females previously kept at LE treatment produced numbers of eggs equivalent to the control females (no treatment is applied). The results suggested that a supply of predator eggs and leaf material might have furnished nutrition and water vapor, respectively, and that this combination prolonged the survival time of N. californicus during storage. Moreover, this approach poses no risk of pest contamination in commercial products.

[Quadricuspid Aortic Valve with Aortic Regurgitation;Report of a Case].

A 65-year-old woman was admitted due to electrocardiographic abnormality and exertional dyspnea. Transthoracic echocardiography revealed quadricuspid aortic valve malformation with severe aortic regurgitation. All 4 cusps were of equal size, and the quadricuspid valve was classified as type a by Hurwitz classification. We replaced it with an 18 mm mechanical valve and her postoperative course was uneventful.

Outcome of anatomical double-bundle ACL reconstruction using hamstring tendons via an outside-in approach.

PURPOSE: To evaluate the clinical outcome of anatomical double-bundle anterior cruciate ligament (ACL) reconstruction using multistranded hamstring tendons via an outside-in approach. METHODS: One hundred and twenty-one patients (mean age 28 ± 10 years) who underwent ACL reconstruction were examined. Using an outside-in femoral drill guide, an upper femoral tunnel for the anteromedial (AM) graft was created just below the superior articular cartilage margin of the medial wall of the lateral condyle through a small incision. A lower femoral tunnel for the posterolateral (PL) graft was drilled in the centre of the inferior-posterior half of the attachment area behind the resident's ridge in the same manner. Two tibial tunnels were created at the centre of the AM and PL bundle footprints of a normal ACL. Patients were evaluated at 24 months postoperatively. RESULTS: According to the IKDC form, 52 knees (43 %) were graded as normal, 64 (53 %) as nearly normal, 1 (1 %) as abnormal and 4 (3 %) as graft rupture due to re-injury. Loss of knee extension of <5° was observed in one patient (1 %). Among 111 patients who were directly evaluated, none showed loss of flexion of <5°. Lachman sign was negative in 103 patients (93 %), while the pivot shift test result was negative or equivalent to that of the contralateral healthy knee in 103 patients (93 %). The mean side-to-side difference in anterior laxity at manual maximum force with the KT-2000 arthrometer(®) was 0.9 ± 1.1 mm, and 94 % of patients showed a range between -1 and +2 mm. CONCLUSION: The anatomical double-bundle outside-in ACL reconstruction provided a satisfactory short-term outcome. LEVEL OF EVIDENCE: Case series, Level IV.