{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T20:06:32Z","timestamp":1789243592281,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"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>Lateral extra\u2010articular tenodesis (LET) has gained increasing use as an adjunct to anterior cruciate ligament reconstruction (ACLR) to improve rotational stability and reduce graft failure. However, concerns remain regarding its potential impact on postoperative morbidity and longer\u2010term joint outcomes. This study aimed to compare postoperative complications, healthcare utilisation and osteoarthritis risk between patients undergoing isolated ACLR and ACLR with LET.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using the TriNetX research network. Patients undergoing primary ACLR with or without LET were identified using CPT. After applying the exclusion criteria, 1:1 propensity score matching was performed, yielding 5021 patients per cohort. Early outcomes at 3 and 6 months included arthrofibrosis\u2010related procedures, wound complications, opioid use, rehabilitation utilisation, emergency room visits and hospital readmissions. Short\u2010term outcomes at 1\u20132 years included subsequent ACLR and meniscal surgery. Mid\u2010term outcomes at 5 years included knee osteoarthritis. A young high\u2010risk subgroup aged 12\u201325 years was analysed for 1\u2010 and 2\u2010year outcomes. Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ACLR\/LET was associated with higher odds of arthrofibrosis\u2010related procedures at 3, 6 and 12 months, including at 1 year (3.4% vs. 2.1%; OR 1.65, 95% CI 1.29\u20132.11;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The LET cohort also had higher odds of wound complications and hospital readmissions at 3 and 6 months, with greater early opioid and rehabilitation utilisation. At 2 years, ACLR\/LET was associated with higher hazards of arthrofibrosis\u2010related procedures (HR 2.01;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and subsequent meniscal surgery (HR 1.25;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), but not subsequent ACLR. ACLR\/LET was also associated with higher hazards of ICD\u2010coded knee osteoarthritis in the primary 5\u2010year analysis (HR 2.24, 95% CI 1.76\u20132.85;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and the 1\u2010year landmark analysis (HR 2.57;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In the young subgroup, ACLR\/LET was associated with lower odds of subsequent ACLR at 1 year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this propensity\u2010matched retrospective study, ACLR with LET was associated with increased early postoperative morbidity, higher hazards of subsequent meniscal surgery and ICD\u2010coded knee osteoarthritis, and no significant reduction in subsequent ACL reconstruction in the primary 2\u2010year time\u2010to\u2010event analysis. Given the retrospective design and potential residual confounding by indication, these findings should be interpreted as associations rather than definitive causal effects of LET augmentation. These results highlight the importance of careful patient selection and counselling when considering LET during ACLR.<\/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.70600","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T19:30:33Z","timestamp":1789241433000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes after anterior cruciate ligament reconstruction with versus without lateral extra\u2010articular tenodesis: A propensity\u2010matched cohort study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6980-3797","authenticated-orcid":false,"given":"Ali","family":"Rteil","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Endeavor Health, an Affiliate of the University of Chicago Pritzker School of Medicine Skokie Illinois USA"},{"name":"Department of Orthopaedic Surgery University of Illinois at Chicago Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koh","family":"Jason","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Endeavor Health, an Affiliate of the University of Chicago Pritzker School of Medicine Skokie Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3002-4199","authenticated-orcid":false,"given":"Farid","family":"Amirouche","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Endeavor Health, an Affiliate of the University of Chicago Pritzker School of Medicine Skokie Illinois USA"},{"name":"Department of Orthopaedic Surgery University of Illinois at Chicago Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,12]]},"reference":[{"issue":"5","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1016\/j.arthro.2018.12.013","article-title":"What are the primary cost drivers of anterior cruciate ligament reconstruction in the United States? A cost\u2010minimization analysis of 14,713 patients","volume":"35","author":"Bokshan SL","year":"2019","journal-title":"Arthroscopy"},{"issue":"7","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1177\/0363546520914936","article-title":"A randomized controlled trial of bone\u2013patellar tendon\u2013bone anterior cruciate ligament reconstruction with and without lateral extra\u2010articular tenodesis: 19\u2010year clinical and radiological follow\u2010up","volume":"48","author":"Castoldi M","year":"2020","journal-title":"Am J Sports Med"},{"issue":"2","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1177\/03635465251376655","article-title":"Lateral extra\u2010articular procedures reduce the risk of revision of anterior cruciate ligament reconstruction in elite athletes: a systematic review and meta\u2010analysis of comparative studies","volume":"54","author":"D'Ambrosi R","year":"2026","journal-title":"Am J Sports 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A multicenter study by the French Arthroscopy Society","volume":"103","author":"Panisset JC","year":"2017","journal-title":"Orthop Traumatol Surg Res"},{"issue":"3","key":"e_1_2_12_35_1","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1016\/j.arthro.2022.11.032","article-title":"Combined lateral extra\u2010articular tenodesis or combined anterolateral ligament reconstruction and anterior cruciate ligament reconstruction improves outcomes compared to isolated reconstruction for anterior cruciate ligament tear: a network meta\u2010analysis of randomized controlled trials","volume":"39","author":"Park Y\u2010B","year":"2023","journal-title":"Arthrosc J Arthrosc Rel Surg"},{"issue":"10","key":"e_1_2_12_36_1","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.1177\/03635465231184389","article-title":"Biomechanical analysis of tibial motion and ACL graft forces after ACLR with and without LET at varying tibial slopes","volume":"51","author":"Pearce 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