The incidence of deep vein thrombosis after anterior cruciate ligament reconstruction: An analysis using routine ultrasonography of 260 patients

Yong Bum Joo; Young Mo Kim; Ju-Ho Song; Byung Kuk An; Yun Ki Kim; Soon Tae Kwon

doi:10.1371/journal.pone.0279136

Peer Review History

Original SubmissionAugust 3, 2022
4 Oct 2022 Decision Letter - Eyüp Serhat Çalık, Editor PONE-D-22-21802The true incidence of deep vein thrombosis after anterior cruciate ligament reconstructionPLOS ONE Dear Dr. Song, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. First of all, I would like to congratulate you for this intersting article entitled 'The true incidence of deep vein thrombosis after anterior cruciate ligament reconstruction'. The manuscript has been evaluated by three reviewers, and their comments are available below. I also want to ask you a few questions: -Do you routinely have ultrasound done to each of your cases after this type of surgical repair? - Have you administered prophylactic anticoagulation to these patients according to your National Guidelines? - Were all DVT patients or those with popliteal DVT asymptomatic? -Why did you perform thoracic CT for pulmonary embolism (PE) in all patients with DVT? - How many patients have you detected PE? You should also add this information to the results section. Please submit your revised manuscript by Nov 18 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. 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If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.” c) If any authors received a salary from any of your funders, please state which authors and which funders. d) If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 3. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability. Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized. Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access. We will update your Data Availability statement to reflect the information you provide in your cover letter. Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: Partly Reviewer #3: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: I Don't Know Reviewer #3: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The authors present a well written manuscript but their study has a number of significant flaws which make it unacceptable for publication. First and foremost, the study is based on a single timepoint ultrasound evaluation for venous thrombosis one week after ACL reconstruction. There is no clinical application or utility of this finding. Without reassessment at a later timepoint with at least clinical information, and preferably repeat ultrasound evaluation, the finding of venous thrombosis in 8.1% (6.2% distal to the popliteal vein) based on US one week after surgery is an incidental finding. Unfortunately, it raises the proverbial question, so what? This finding is not surprising or concerning and will not change practice. Ideally, in order to have a clinically relevant study worthy of publication, the patients would have been re-evaluated serially, at least at 1, 3 and 6 months after surgery, with US to determine the natural history of these otherwise incidental findings. The suspicion is that the vast majority will resolve without any clinical manifestation. There is no indication for therapeutic treatment of the distal thromboses and it is not clear if the asymptomatic popliteal vein thromboses should be treated. Specific comments Lines 71-3: Delete this sentence Lines 97-98: Was tourniquet used during these surgeries? If so, what was the average tourniquet time? Lines 106-7: Distal DVT is not considered clinically important. Without serial repeat imaging, these should be excluded. Lines 107-8: CT pulmonary angiography was performed for distal DVT? Did anyone have a PE? The CT angio results should be reported. Lines 109-113: Why not tourniquet time? Lines 121-2: Recommend regression for proximal DVT only. This cohort is atypical for ACL reconstruction as it is older, more male and more heavily smoking than most ACL reconstruction cohorts. This may bias the results and should be explored at length in the discussion. Reviewer #2: Deep vein thrombosis is an important issue that is frequently encountered after orthopedic surgical interventions. In particular, screening of the asymptomatic patient group has a very important place in this regard. In this study, I have some questions to the authors. 1- It is stated that it is a retrospective study. Can you explain the fact that in a retrospective study, control USG was requested one week after the surgical intervention? Is it a routine practice to perform control USG on all patients? 2- Identification of risk factors for DVT was stated as the aim of the study. However, the data on this subject is limited in the discussion and findings section. Only one analysis was made on smoking. I think it would be appropriate to change the purpose of the study or to discuss other risk factors in the discussion section. Reviewer #3: This manuscript is the very interesting research about incidence of DVT after ACL reconstruction. The incidence of DVT after orthopaedic surgery is a serious problem, and it is important to examine the incidence of DVT after ACL reconstruction. I think this paper is a good paper, but there is a problem that it does not confirm that DVT did not occur before surgery. The ACL injury is a traumatic injury and may have been concurrent with deep vein injury at the time of injury, and DVT may have occurred preoperatively. I consider that the high incidence of postoperative DVT in multiligament injuries is also due to the high-energy injury at the time of injury, and the possibility that DVT had already occurred before surgery cannot be ruled out. We believe it is necessary to make an accurate statement on this point. These points should be revised for this study to be relevant for publication in the PLOS ONE. Title For the aforementioned reasons, I consider the expression "True" to be an overstatement. Please change the title. Introduction, Materials and Methods, Results, Figures Well written. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: Yes: FERHAT BORULU Reviewer #3: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: review comment 20221001.docx https://doi.org/10.1371/journal.pone.0279136.r001
Revision 1
27 Oct 2022 Author Response First of all, I would like to congratulate you for this intersting article entitled 'The true incidence of deep vein thrombosis after anterior cruciate ligament reconstruction'. The manuscript has been evaluated by three reviewers, and their comments are available below. I also want to ask you a few questions: - Do you routinely have ultrasound done to each of your cases after this type of surgical repair? Ultrasonography at one week postoperatively was routinely performed during the study period. However, the postoperative protocol has now been changed based on the results of this study. - Have you administered prophylactic anticoagulation to these patients according to your National Guidelines? Thromboprophylaxis was not routinely applied except for anti-embolism stockings and early postoperative ambulation (Line 100–101) because the current guidelines did not advocate for routine anticoagulation in knee arthroscopy. - Were all DVT patients or those with popliteal DVT asymptomatic? All popliteal DVT patients had no related symptoms (Line 151). -Why did you perform thoracic CT for pulmonary embolism (PE) in all patients with DVT? - How many patients have you detected PE? You should also add this information to the results section. CT for pulmonary embolism was performed only for the patients with proximal DVT, which was determined after consultation with pulmonologists. There was no pulmonary embolism detected on CT scans. The manuscript has been revised accordingly (Line 108–110, 150–151). 3. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability. Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized. Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access. We will update your Data Availability statement to reflect the information you provide in your cover letter. Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: Partly Reviewer #3: Partly 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: I Don't Know Reviewer #3: Yes 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The authors present a well written manuscript but their study has a number of significant flaws which make it unacceptable for publication. First and foremost, the study is based on a single timepoint ultrasound evaluation for venous thrombosis one week after ACL reconstruction. There is no clinical application or utility of this finding. Without reassessment at a later timepoint with at least clinical information, and preferably repeat ultrasound evaluation, the finding of venous thrombosis in 8.1% (6.2% distal to the popliteal vein) based on US one week after surgery is an incidental finding. Unfortunately, it raises the proverbial question, so what? This finding is not surprising or concerning and will not change practice. Ideally, in order to have a clinically relevant study worthy of publication, the patients would have been re-evaluated serially, at least at 1, 3 and 6 months after surgery, with US to determine the natural history of these otherwise incidental findings. The suspicion is that the vast majority will resolve without any clinical manifestation. There is no indication for therapeutic treatment of the distal thromboses and it is not clear if the asymptomatic popliteal vein thromboses should be treated. Specific comments Lines 71-3: Delete this sentence The manuscript has been revised accordingly. Lines 97-98: Was tourniquet used during these surgeries? If so, what was the average tourniquet time? A tourniquet was routinely used and tourniquet time was presented instead of surgical time, as suggested by another reviewer (Line 36, 114). The average surgical time was 99.0 ± 17.1 minutes (Table 1). Lines 106-7: Distal DVT is not considered clinically important. Without serial repeat imaging, these should be excluded. The manuscript has been revised accordingly (Line 106–108). Lines 107-8: CT pulmonary angiography was performed for distal DVT? Did anyone have a PE? The CT angio results should be reported. CT for pulmonary embolism was performed only for the patients with proximal DVT, which was determined after consultation with pulmonologists. There was no pulmonary embolism detected on CT scans. The manuscript has been revised accordingly (Line 108–110, 150–151). Lines 109-113: Why not tourniquet time? As suggested, tourniquet time was presented instead of surgical time (Line 36, 114). Lines 121-2: Recommend regression for proximal DVT only. As suggested, the design of the study has been revised, focusing on proximal DVT only (Line 38, 123–125, 161–163, Table 2). Accordingly, the results and conclusion have been slightly changed (Line 44–46, 49, 161–163, 176–177, 238). This cohort is atypical for ACL reconstruction as it is older, more male and more heavily smoking than most ACL reconstruction cohorts. This may bias the results and should be explored at length in the discussion. The discussion has been revised accordingly (Line 219–227). Reviewer #2: Deep vein thrombosis is an important issue that is frequently encountered after orthopedic surgical interventions. In particular, screening of the asymptomatic patient group has a very important place in this regard. In this study, I have some questions to the authors. 1- It is stated that it is a retrospective study. Can you explain the fact that in a retrospective study, control USG was requested one week after the surgical intervention? Is it a routine practice to perform control USG on all patients? Ultrasonography at one week postoperatively was routinely performed during the study period. However, the postoperative protocol has now been changed based on the results of this study. 2- Identification of risk factors for DVT was stated as the aim of the study. However, the data on this subject is limited in the discussion and findings section. Only one analysis was made on smoking. I think it would be appropriate to change the purpose of the study or to discuss other risk factors in the discussion section. As suggested, the purpose of the study has been revised (Line 30, 88). Reviewer #3: This manuscript is the very interesting research about incidence of DVT after ACL reconstruction. The incidence of DVT after orthopaedic surgery is a serious problem, and it is important to examine the incidence of DVT after ACL reconstruction. I think this paper is a good paper, but there is a problem that it does not confirm that DVT did not occur before surgery. The ACL injury is a traumatic injury and may have been concurrent with deep vein injury at the time of injury, and DVT may have occurred preoperatively. I consider that the high incidence of postoperative DVT in multiligament injuries is also due to the high-energy injury at the time of injury, and the possibility that DVT had already occurred before surgery cannot be ruled out. We believe it is necessary to make an accurate statement on this point. These points should be revised for this study to be relevant for publication in the PLOS ONE. Title For the aforementioned reasons, I consider the expression "True" to be an overstatement. Please change the title. As suggested, ‘true’ was removed and the title has been changed to ‘The incidence of deep vein thrombosis after anterior cruciate ligament reconstruction: an analysis using routine ultrasonography of 260 patients’. Introduction, Materials and Methods, Results, Figures Well written. Attachments Attachment Submitted filename: Response to Reviewers Comments.docx https://doi.org/10.1371/journal.pone.0279136.r002
24 Nov 2022 Decision Letter - Eyüp Serhat Çalık, Editor PONE-D-22-21802R1The incidence of deep vein thrombosis after anterior cruciate ligament reconstruction: an analysis using routine ultrasonography of 260 patientsPLOS ONE Dear Dr. Song, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Jan 08 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Eyüp Serhat Çalık Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: Dear Authors We reviewed the revised version of your article and your responses to the reviewers. Your manuscript has been additionally evaluated by one more reviewer. We request that you re-upload your work, which you will edit in accordance with the recommendations of Reviewer 4, as soon as possible. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #4: (No Response) ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #4: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #4: (No Response) ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #4: (No Response) ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #4: (No Response) ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #4: The purpose of this paper was to assess the incidence of DVT after ACL reconstruction, regardless of symptom manifestation, by analyzing 260 patients. They reported the incidence of DVT to be 8.1%, which is higher than the previously known incidence. 1. Some values in Table 2 should be checked. For example, a. The lower bound of CI for age = 1.0 which is the same as original exp(beta)? b. CI for diabetes mellitus c. Lower bound of CI for OI. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #4: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0279136.r003
Revision 2
25 Nov 2022 Author Response Reviewer #4: The purpose of this paper was to assess the incidence of DVT after ACL reconstruction, regardless of symptom manifestation, by analyzing 260 patients. They reported the incidence of DVT to be 8.1%, which is higher than the previously known incidence. 1. Some values in Table 2 should be checked. For example, a. The lower bound of CI for age = 1.0 which is the same as original exp(beta)? b. CI for diabetes mellitus c. Lower bound of CI for OI. As suggested, 95% CI has been presented to two decimal places to avoid confusion. The manuscript has also been revised accordingly. Regarding the CI of diabetes mellitus, the values have been replaced with NA (not applicable). Attachments Attachment Submitted filename: Response to Reviewers Comments.docx https://doi.org/10.1371/journal.pone.0279136.r004
1 Dec 2022 Decision Letter - Eyüp Serhat Çalık, Editor The incidence of deep vein thrombosis after anterior cruciate ligament reconstruction: an analysis using routine ultrasonography of 260 patients PONE-D-22-21802R2 Dear Dr. Song, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Eyüp Serhat Çalık Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0279136.r005
Formally Accepted
5 Dec 2022 Acceptance Letter - Eyüp Serhat Çalık, Editor PONE-D-22-21802R2 The incidence of deep vein thrombosis after anterior cruciate ligament reconstruction: an analysis using routine ultrasonography of 260 patients Dear Dr. Song: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Eyüp Serhat Çalık Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0279136.r006

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