{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:46:37Z","timestamp":1789231597824,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100001225","name":"Marathon","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001225","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to evaluate anterior cruciate ligament (ACL) graft rupture in a selective approach to lateral extra\u2010articular tenodesis (LET), with a focus on the impact of posterior tibial slope (PTS) and static anterior tibial translation (SATT) on graft rupture rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included patients who underwent primary ACL reconstruction (ACLR) using hamstrings autograft between 2014 and 2018, with a minimum follow\u2010up of 6 years. LET was performed based on specific indications (pivot shift grade 2\u20133, hyperlaxity and genu recurvatum) in adult patients and systematically in those under 18 years of age. Demographic variables, associated procedures, ACL graft rupture and time to rupture were recorded. Preoperative radiographs were used to measure PTS and SATT. Univariate and multivariate analyses were performed to identify risk factors for graft rupture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 839 patients were eligible. Follow\u2010up was obtained for 705 patients (mean age 30.5\u2009\u00b1\u200910.9 years; 38% female). Forty\u2010one ACL graft ruptures were identified (5.8%). Among adult patients (\u226518 years), the graft rupture rate was 4.5% in the ACLR\u2009+\u2009LET group versus 5.4% in the isolated ACLR group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.673). Risk factors significantly associated with graft rupture included PTS\u2009\u2265\u200912\u00b0 (odds ratio [OR]\u2009=\u20093.0; 95% confidence interval [CI]\u2009=\u20091.5\u20136.2;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), SATT\u2009\u2265\u20095\u2009mm (OR\u2009=\u20092.7; 95% CI\u2009=\u20091.3\u20135.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), age\u2009&lt;\u200918 years (OR\u2009=\u20092.3; 95% CI\u2009=\u20091.0\u20133.9;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017) and lateral meniscal injuries (OR\u2009=\u20092.3; 95% CI\u2009=\u20091.1\u20135.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041). The highest graft rupture rate occurred in patients &lt;18 years with both PTS\u2009\u2265\u200912\u00b0 and SATT\u2009\u2265\u20095\u2009mm (2\/7; 29%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A selective, indication\u2010based approach to LET in patients \u226518 years and systematic LET in patients under 18 years of age was associated with low ACL graft rupture rates. Higher PTS, SATT, younger age and lateral meniscal injury were associated with an increased risk of graft rupture. These findings should be interpreted within the limitations of the study design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective case\u2013control study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70450","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:17:16Z","timestamp":1779275836000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Selective approach to lateral extra\u2010articular tenodesis achieves low anterior cruciate ligament graft rupture rates, while posterior tibial slope and static anterior tibial translation remain major risk factors"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2173-6167","authenticated-orcid":false,"given":"David","family":"Mazy","sequence":"first","affiliation":[{"name":"Lyon Ortho Clinic, Orthopedic Surgery Department Clinique de la Sauvegarde Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Cance","sequence":"additional","affiliation":[{"name":"Lyon Ortho Clinic, Orthopedic Surgery Department Clinique de la Sauvegarde Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael James","family":"Dan","sequence":"additional","affiliation":[{"name":"Macquarie University Hospital Macquarie University Sydney New South Wales Australia"},{"name":"East Coast Athletic Orthopaedics Merewether New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Angelelli","sequence":"additional","affiliation":[{"name":"Lyon Ortho Clinic, Orthopedic Surgery Department Clinique de la Sauvegarde Lyon France"},{"name":"Clinica Ortopedica e Traumatologica 2 IRCCS Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"Favroul","sequence":"additional","affiliation":[{"name":"Lyon Ortho Clinic, Orthopedic Surgery Department Clinique de la Sauvegarde Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautier","family":"Beckers","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Klinikum Grobhardern Ludwig\u2010Maximilians\u2010University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Henri","family":"Dejour","sequence":"additional","affiliation":[{"name":"Lyon Ortho Clinic, Orthopedic Surgery Department Clinique de la Sauvegarde Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"issue":"7","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1177\/0363546514531396","article-title":"Surgical predictors of early revision surgery after anterior cruciate ligament reconstruction: results from the Swedish National Knee Ligament Register on 13,102 patients","volume":"42","author":"Andernord D","year":"2014","journal-title":"Am J Sports Med"},{"issue":"9","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1177\/0363546512454414","article-title":"Survival of the anterior cruciate ligament graft and the contralateral ACL at a minimum of 15 years","volume":"40","author":"Bourke HE","year":"2012","journal-title":"Am J Sports Med"},{"issue":"3","key":"e_1_2_11_4_1","first-page":"195","article-title":"[Evaluation of methods for radiographic measurement of the tibial slope. 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