{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T11:40:13Z","timestamp":1792237213109,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"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":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>In revision anterior cruciate ligament reconstruction (R\u2010ACLR), adding a lateral extra\u2010articular procedure (LEAP) reduces graft failure and postoperative laxity. Iliotibial band (ITB)\u2010based techniques may avoid patellar tendon harvesting morbidity, but evidence in adults, particularly in revision cases, remains limited. We compared clinical outcomes at \u22652 years after R\u2010ACLR using a modified ITB\u2010allograft (ITB\u2010AG) technique versus bone\u2013patellar tendon\u2013bone with lateral extra\u2010articular tenodesis (BPTB\u2010LET). It was hypothesized that no difference in retear rates between techniques would be found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis of prospectively collected data was performed on consecutive adult patients (\u226518 years) undergoing R\u2010ACLR between 2018 and 2023. Patients were included if they received ITB\u2010AG or BPTB\u2010LET R\u2010ACLR, if surgery occurred within 24 months of graft failure and follow\u2010up was \u22652 years. Exclusions were multiligament injury, concomitant osteotomy or refusal to participate. Primary outcome was graft retear, and secondary outcomes were International Knee Documentation Committee (IKDC) subjective score, Lysholm score, complications, side\u2010to\u2010side anterior laxity and pivot\u2010shift grade. Comparisons between groups were performed using Student's\n                      <jats:italic>t<\/jats:italic>\n                      test or Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test for continuous variables and chi\u2010square or Fisher exact test for categorical variables, with statistical significance set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred ninety\u2010five patients were analysed (BPTB\u2010LET,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009105; ITB\u2010AG,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200990). Groups were similar at baseline; follow\u2010up was 38\u2009\u00b1\u20099 months for BPTB\u2010LET and 34\u2009\u00b1\u20097 months for ITB\u2010AG (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0005). Meniscal tears and repairs were more frequent with ITB\u2010AG; graft diameter was slightly smaller with ITB\u2010AG (8.8\u2009\u00b1\u20090.7\u2009mm for ITB\u2010AG vs. 9.3\u2009\u00b1\u20090.5\u2009mm for BPTB\u2010LET;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001). Retear rates were not different (5.7% BPTB\u2010LET vs. 4.4% ITB\u2010AG;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7551). IKDC was higher with ITB\u2010AG (90.7\u2009\u00b1\u200910.8 vs. 88.3\u2009\u00b1\u200910.1;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0026); 97% (BPTB\u2010LET) and 93% (ITB\u2010AG) achieved the IKDC Patient Acceptable Symptom State (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.3073). Lysholm was higher with ITB\u2010AG (94.6\u2009\u00b1\u200910.8 vs. 90.8\u2009\u00b1\u20099.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001). A negative pivot\u2010shift was found in 98.9% (ITB\u2010AG) versus 66.7% (BPTB\u2010LET) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001), while KT\u20101000 anterior laxity did not differ significantly (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.1164). Complication rates were similar (4.7% vs. 5.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At midterm follow\u2010up, a modified ITB\u2010AG technique provided comparable graft survival to BPTB\u2010LET, with similarly low complication rates. Patient\u2010reported outcome measures were statistically higher and a greater proportion of patients demonstrated a negative pivot\u2010shift test in the ITB\u2010AG group, although the clinical relevance of these differences remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70496","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:26:04Z","timestamp":1781789164000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Revision ACL reconstruction using a modified iliotibial band\u2013allograft technique for combined ACL and lateral extra\u2010articular procedure achieves comparable outcomes to bone\u2013patellar tendon\u2013bone with modified Lemaire"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6718-7987","authenticated-orcid":false,"given":"Victor","family":"Mas","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery H\u00f4pital Pierre Paul Riquet, CHU de Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Giardino Moreira da Silva","sequence":"additional","affiliation":[{"name":"Instituto de Ortopedia e Traumatologia Clinical Hospital FMUSP S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ripoll","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery H\u00f4pital Pierre Paul Riquet, CHU de Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Carrozzo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Universit\u00e0 degli Studi \u201cLink Campus University\u201d Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regis","family":"Pailhe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique Aguilera Ramsay Sant\u00e9 Biarritz France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Courtot","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery H\u00f4pital Pierre Paul Riquet, CHU de Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilo","family":"Helito","sequence":"additional","affiliation":[{"name":"Instituto de Ortopedia e Traumatologia Clinical Hospital FMUSP S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Cavaignac","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery H\u00f4pital Pierre Paul Riquet, CHU de Toulouse Toulouse 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