{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:05:17Z","timestamp":1790161517531,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"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>Combined intra\u2010 and extra\u2010articular anterior cruciate ligament (ACL) reconstruction has gained renewed interest to improve rotational stability and reduce graft failure. This study evaluated graft re\u2010rupture rates, functional and return\u2010to\u2010sport (RTS) outcomes at a minimum 6\u2010year follow\u2010up after primary reconstruction using a modified MacIntosh iliotibial band (ITB) technique with gracilis augmentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single\u2010centre cohort study included patients from the FAST Cohort (French Prospective Anterior Cruciate Ligament Reconstruction Cohort Study) who underwent primary reconstruction using this technique between January 2015 and October 2019. The primary outcome was graft re\u2010rupture. Patient\u2010reported outcome measures, RTS outcomes and complications were assessed at final follow\u2010up. Multivariable logistic regression identified factors associated with graft re\u2010rupture and RTS at the pre\u2010injury level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 265 patients were included in graft re\u2010rupture and complication analyses, with a mean follow\u2010up of 84.3\u2009\u00b1\u200910.7 months. Graft re\u2010rupture occurred in 13 patients (4.9%). Complications other than graft failure occurred in 5 patients (1.9%). Additional surgical procedures excluding ACL revision were required in 13 patients (4.9%), most commonly meniscectomy for secondary meniscal lesions (4.2%). Functional outcomes were analysed in 252 patients after excluding graft re\u2010ruptures and improved significantly compared with preoperative values (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with median subjective International Knee Documentation Committee and Lysholm scores of 92.0 and 95.0, respectively. Among 249 patients who practised sport before injury, 228 (91.6%) returned to sport, including 154 (61.8%) who returned to the same sport, of whom 69 (44.8%) returned to their pre\u2010injury level. Median time to RTS was 8.0 months. Younger age and medial meniscal tear were independently associated with graft re\u2010rupture.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Primary ACL reconstruction using a modified MacIntosh ITB technique with gracilis augmentation resulted in a low graft re\u2010rupture rate, favourable patient\u2010reported outcome scores and a high overall RTS rate at a minimum 6\u2010year follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, retrospective case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70626","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T10:07:32Z","timestamp":1790158052000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low graft re\u2010rupture rate after primary ACL reconstruction using a modified MacIntosh iliotibial band technique with gracilis augmentation: Minimum 6\u2010year follow\u2010up"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8035-5089","authenticated-orcid":false,"given":"Baptiste","family":"Bouyge","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"},{"name":"Department of Orthopaedic and Trauma Surgery H\u00f4pital Charles Nicole, CHU de Rouen Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Gerometta","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4231-6700","authenticated-orcid":false,"given":"Eug\u00e9nie","family":"Valentin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2611-3938","authenticated-orcid":false,"given":"Mohamad","family":"Moussa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"},{"name":"Department of Orthopaedic Surgery Groupe Hospitalier S\u00e9lestat\u2010Obernai S\u00e9lestat France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1143-0961","authenticated-orcid":false,"given":"Nikolaos","family":"Lepidas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Khiami","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5712-7876","authenticated-orcid":false,"given":"Olivier","family":"Grimaud","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9689-1578","authenticated-orcid":false,"given":"Nicolas","family":"Lef\u00e8vre","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7716-4221","authenticated-orcid":false,"given":"Yoann","family":"Bohu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1604-8194","authenticated-orcid":false,"given":"Alexandre","family":"Hardy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique du sport Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"issue":"12","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671231214803","article-title":"Comparison of revision ACL reconstruction using iliotibial band augmented with allograft versus bone\u2013patellar tendon\u2013bone autograft with lateral 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