{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:51:47Z","timestamp":1792083107623,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":47,"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>The management of anterior cruciate ligament (ACL) tears in older adults remains controversial, although recent evidence suggests an increasing trend toward surgical treatment. To date, no studies have specifically investigated the outcomes of combined ACL reconstruction (ACLR) with over\u2010the\u2010top (OTT) technique and lateral extra\u2010articular tenodesis (LET) in this population. The aim of this study was to evaluate clinical outcomes and failure rates of ACLR using OTT plus LET in patients aged 55 years or older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients aged \u226555 years who underwent primary ACLR with OTT and LET techniques and had a minimum follow\u2010up of 2 years were included. Clinical outcomes were assessed using clinical scores, such as VAS, Lysholm, KOOS, comparing preoperative and post\u2010operative values. Patient Acceptable Symptom State (PASS) thresholds were applied to KOOS subscales. Reoperations and graft failures were also recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010eight patients met the inclusion criteria, with a mean age of 60.1\u2009\u00b1\u20093.2 years and a mean follow\u2010up of 6.5\u2009\u00b1\u20093.8 years. One graft failure (3.6%) and one reoperation (3.6%) were observed. Significant improvements were noted in all clinical scores. The mean Lysholm score increased from 55.4\u2009\u00b1\u200915.9 preoperatively to 96.6\u2009\u00b1\u20096.6 postoperatively. KOOS subscales showed marked improvement, particularly in Quality of Life (41.6\u2009\u00b1\u200920.2 to 90.3\u2009\u00b1\u200912.9) and Pain (68.7\u2009\u00b1\u200912.1 to 94.2\u2009\u00b1\u20095.7).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ACLR with OTT and LET techniques in older patients demonstrated low failure rates and favourable clinical outcomes. Larger studies are needed to confirm these findings and to establish the role of this combined technique in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70889","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:20:53Z","timestamp":1786965653000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes and failure rates of combined \u2018Over\u2010the\u2010Top\u2019 anterior cruciate ligament reconstruction and lateral extra\u2010articular tenodesis in a cohort of patients with an average age of 60 years"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7035-7050","authenticated-orcid":false,"given":"Lorenzo","family":"Bini","sequence":"first","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences DIBINEM University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3065-9212","authenticated-orcid":false,"given":"Gian Andrea","family":"Lucidi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences DIBINEM University of Bologna Bologna Italy"},{"name":"2nd Orthopaedic and Traumatologic Clinic IRCCS Rizzoli Orthopaedic Institute Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Agostinone","sequence":"additional","affiliation":[{"name":"2nd Orthopaedic and Traumatologic Clinic IRCCS Rizzoli Orthopaedic Institute Bologna 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