{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:51:16Z","timestamp":1792083076551,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the rate of early complications and reoperation after anterior cruciate ligament reconstruction (ACLR) using an over\u2010the\u2010top technique with lateral extra\u2010articular tenodesis (LET) in skeletally immature patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective case series included all skeletally immature patients undergoing ACLR with an over\u2010the\u2010top technique and LET augmentation between June 2022 and August 2025, performed by a single surgeon. Tibial tunnel strategy (extra\u2010physeal, supra\u2010physeal or trans\u2010physeal) was selected based on remaining growth. Skeletal immaturity was defined by the presence of open physes on knee magnetic resonance imaging. All patients had a minimum follow\u2010up of 9 months. The primary outcome was the rate of complications and reoperations within the first 9 post\u2010operative months, selected to capture events occurring during the rehabilitation phase prior to return to sport. Secondary outcomes included patient characteristics, sports activity, surgical technique and associated meniscal injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty\u2010four patients (mean age 14.7\u2009\u00b1\u20091.7 years; 77% male) were included, with a mean follow\u2010up of 20.0\u2009\u00b1\u20099.7 months. Surgical techniques included extra\u2010physeal (12%), supra\u2010physeal (48%) and trans\u2010physeal (40%) approaches. Concomitant meniscal lesions were treated in 71 patients. No major complications were observed. Minor complications occurred in 20.2% of patients, with similar rates across techniques. The most common events were transient stiffness (9.5%), early swelling\/fever (8.3%), delayed wound healing (7.4%) and hardware irritation (2.4%). Reoperations occurred in 4.7% of cases, all before return to sport, and included hardware removal, wound debridement and joint lavage. No deep infections or septic arthritis were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ACLR using an over\u2010the\u2010top technique with LET in skeletally immature patients was not associated with major complications during the early postoperative period. Minor complications were observed in approximately one\u2010fifth of patients and were generally self\u2010limiting or managed without long\u2010term consequences. Longer follow\u2010up is required to evaluate growth\u2010related outcomes and graft survivorship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70852","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T08:46:52Z","timestamp":1785228412000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age\u2010specific over\u2010the\u2010top anterior cruciate ligament (ACL) reconstruction and lateral extra\u2010articular tenodesis (LET) in skeletally immature patients: No major complications during early follow\u2010up"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8442-9768","authenticated-orcid":false,"given":"Ashraf","family":"Hantouly","sequence":"first","affiliation":[{"name":"McMaster University Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Rossi","sequence":"additional","affiliation":[{"name":"Clinica Ortopedica E Traumatologica II, IRCCS Istituto Ortopedico Rizzoli Bologna Italy"},{"name":"Dipartimento di Scienze Biomediche e Neuromotorie (DIBINEM) Universit\u00e0 di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna","family":"Cascone","sequence":"additional","affiliation":[{"name":"Clinica Ortopedica E Traumatologica II, IRCCS Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Andrea","family":"Lucidi","sequence":"additional","affiliation":[{"name":"Clinica Ortopedica E 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