{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:59:27Z","timestamp":1790312367110,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the clinical outcomes of patients with increased posterior tibial slope (PTS \u226512\u00b0) undergoing primary anterior cruciate ligament reconstruction (ACLR) with concomitant lateral extra\u2010articular tenodesis (LET) and to determine whether the addition of LET mitigates the elevated risk of graft failure associated with increased tibial slope.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center retrospective cohort study included patients \u226516\u2009years who underwent primary ACLR with LET between 2013 and 2022 with a minimum 2\u2010year follow\u2010up. Patients were stratified by PTS \u226512\u00b0 versus &lt;12\u00b0 and required preoperative lateral radiographs for slope measurement and high\u2010risk features (pivot shift \u22652, Beighton \u22654, or return to pivoting sports). Outcomes included graft failure, residual pivot shift, complications, and patient\u2010reported outcomes (International Knee Documentation Committee and Lysholm). Achievement of minimal clinically important difference was assessed. Multivariable logistic regression and Cox proportional hazards analysis were performed to identify independent predictors of graft failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 289 patients (mean follow\u2010up, 38\u2009months) were included: 45 with PTS \u226512\u00b0 (13.0\u00b0\u2009\u00b1\u20091.2\u00b0) and 244 with PTS &lt;12\u00b0 (8.1\u00b0\u2009\u00b1\u20091.5\u00b0). Graft failure occurred in 24% versus 18%, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.411). On multivariable Cox proportional hazards analysis, no independent predictor of graft failure was identified, including PTS (hazard ratio, 1.07 per degree; 95% confidence interval, 0.95\u20101.19;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.260). Complications and contralateral anterior cruciate ligament injury rates were similar between groups. On sex\u2010disaggregated analysis, similar patterns were observed in both male and female cohorts, with no significant between\u2010group differences in graft failure, retear, or complication rates by tibial slope. Patient\u2010reported outcomes were comparable at all time points. At final follow\u2010up, minimal clinically important difference achievement for International Knee Documentation Committee and Lysholm was 98% and 100%, respectively, with no between\u2010group differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In high\u2010risk patients with a PTS of \u226512\u00b0, primary ACLR with LET led to similar clinical results as patients with a PTS of 12 or less. A PTS of \u226512\u00b0 may be considered an indication for the addition of an LET during primary ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70616","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:18:48Z","timestamp":1790309928000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Graft Failure Rate Is Similar Between Groups With and Without Increased Posterior Tibial Slope After Primary Anterior Cruciate Ligament Reconstruction With Lateral Extra\u2010articular Tenodesis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3003-3316","authenticated-orcid":false,"given":"M. Lane","family":"Moore","sequence":"first","affiliation":[{"name":"Mayo Clinic Department of Orthopedic Surgery  Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph C.","family":"Brinkman","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Orthopedic Surgery  Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7940-753X","authenticated-orcid":false,"given":"Eric","family":"Wang","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Scottsdale Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collin L.","family":"Braithwaite","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Orthopedic Surgery  Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2302-0552","authenticated-orcid":false,"given":"Eugenia","family":"Lin","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Orthopedic Surgery  Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kostas J.","family":"Economopoulos","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Orthopedic Surgery  Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1177\/03635465261416923","article-title":"Having a revision ACL reconstruction is worse than tearing the contralateral ACL and undergoing reconstruction: A MOON cohort study","volume":"54","author":"Magnussen RA","year":"2026","journal-title":"Am J Sports 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