{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:20:32Z","timestamp":1790475632257,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To leverage the power of a large national sample to assess the risk of arthrofibrosis following anterior cruciate ligament reconstruction (ACLR) + lateral extra\u2010articular procedure (LEAP) augmentation compared with ACLR alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent either primary ACLR\u2009+\u2009LEAP or ACLR alone from October 2015 to April 2023 were identified from a large national insurance database (PearlDiver). Demographic data, surgical information, and comorbidities were collected. The primary outcome was arthrofibrosis requiring manipulation under anesthesia and\/or lysis of adhesions at 6\u2009months. Time\u2010to\u2010event analyses were utilized to compare groups. Secondary outcomes included 90\u2010day medical complications and 2\u2010 and 5\u2010year ACLR revision rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 102,757 patients (860 ACLR\u2009+\u2009LEAP, 101,897 ACLR alone) with an average follow\u2010up of 3.7\u2009years. Patients undergoing ACLR\u2009+\u2009LEAP had a significantly increased risk of arthrofibrosis requiring intervention at 6 months (2.6% vs 1.2%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), 1 year (3.1% vs 1.6%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), and 2 years (3.3% vs 1.8%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) compared with patients undergoing isolated ACLR. These results were held in an adjusted analysis controlling for age, sex, concomitant meniscal repair, obesity, smoking, and comorbidities (hazard ratio 1.78, 95% confidence interval 1.16\u20102.71,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.007). There were no significant differences in wound, thromboembolic, or other 90\u2010day medical complications (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u2009.05 for all), whereas ACLR\u2009+\u2009LEAP was associated with significantly lower ACLR revision rates at 2 and 5\u2009years (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2264\u2009.003 for both).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The addition of a LEAP to primary ACLR was associated with an increased risk of developing arthrofibrosis compared with ACLR alone. Importantly, differences were relatively small (absolute risk difference ~1.4 percentage points at 6\u2009months), and LEAPs remain an important tool for reducing ACLR revision rates in many patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70335","type":"journal-article","created":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T20:51:08Z","timestamp":1782679868000},"page":"2186-2194","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lateral Extra\u2010articular Procedure Augmentation Is Associated With an Increased Risk of Arthrofibrosis Following Anterior Cruciate Ligament Reconstruction"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8943-0987","authenticated-orcid":false,"given":"Nathan H.","family":"Varady","sequence":"first","affiliation":[{"name":"Department of Sports Medicine Hospital for Special Surgery  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3621-5201","authenticated-orcid":false,"given":"Suhas","family":"Parise","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Hospital for Special Surgery  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M.","family":"Inclan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Arkansas for Medical Sciences  Little Rock Arkansas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0363-3482","authenticated-orcid":false,"given":"Kyle N.","family":"Kunze","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Hospital for Special Surgery  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil S.","family":"Ranawat","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Hospital for Special Surgery  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Riley J.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Hospital for Special Surgery  New York New York 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