{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T14:21:56Z","timestamp":1793283716682,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of adding lateral extra\u2010articular tenodesis (LET) to primary anterior cruciate ligament reconstruction (ACLR) in competitive female soccer athletes with greater preoperative generalized ligamentous laxity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective review of female high school and collegiate soccer players who underwent primary ACLR from 2013 to 2021, with a minimum of 2 years of follow\u2010up, was conducted. Participants were divided into 2 groups: those who received ACLR alone and those who received ACLR with LET. Generalized ligamentous laxity was defined as a Beighton score \u22654 and was not considered an indication for LET. Anterior cruciate ligament (ACL) autografts included the quadriceps, bone\u2212patellar tendon\u2212bone, and hamstrings in both groups. Patient demographics and physical examination findings, including pivot shift results, were collected. Positive pivot\u2010shift refers to a grade \u22652. Patient outcomes included graft failure (defined as ACL retear), International Knee Documentation Committee score, Lysholm score, return to sport, and complications. Independent\n                      <jats:italic>t<\/jats:italic>\n                      tests, \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests, and Mann\u2010Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests were conducted to compare outcomes between the 2 groups. Minimally clinical important difference was calculated from preoperative to final follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 133 female soccer players who underwent ACLR met inclusion criteria, including 43 patients that received an ACLR + LET and 90 patients who underwent isolated ACLR. Average follow\u2010up was 39.0 and 36.1 months in the LET group and the control group, respectively. Patients who underwent LET had a greater generalized ligamentous laxity rate (48.8% vs 18.9%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and greater median Beighton score (3.0 vs 1.0;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) than those without LET. There was a similar rate of graft failure in patients who underwent LET compared with the control group (4.7% vs 3.0%;\n                      <jats:italic>P<\/jats:italic>\n                      = .658). On the basis of minimally clinical important difference thresholds, there were no clinically relevant differences in International Knee Documentation Committee or Lysholm scores noted between the 2 groups. Return\u2010to\u2010sport rates also were comparable between the LET and control cohorts (90.7% vs 85.6%;\n                      <jats:italic>P<\/jats:italic>\n                      = .807).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The addition of LET during ACLR in female soccer players with preoperative generalized ligamentous laxity yields graft retear and return\u2010to\u2010sport rates comparable with those of athletes without ligamentous laxity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2025.03.045","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T17:27:30Z","timestamp":1743701250000},"page":"4136-4144","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":10,"title":["Lateral Extra\u2010Articular Tenodesis With Iliotibial Band in Anterior Cruciate Ligament Autograft Reconstruction for Female Soccer Athletes With Generalized Ligamentous Laxity Yields Graft Failure and Return\u2010to\u2010Sport Rates Comparable With Athletes Without Generalized Laxity"],"prefix":"10.1002","volume":"41","author":[{"given":"Romir","family":"Parmar","sequence":"first","affiliation":[{"name":"University of Arizona College of Medicine \u2013 Phoenix Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sailesh V.","family":"Tummala","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic Arizona Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph C.","family":"Brinkman","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic Arizona Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kostas J.","family":"Economopoulos","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic Arizona Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,1]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1941738114535184"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0813-1"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-094573"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516648439"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518808006"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211044458"},{"key":"e_1_2_3_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671221114353"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546504269591"},{"key":"e_1_2_3_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354659402200208"},{"key":"e_1_2_3_11_1","first-page":"594","article-title":"Sex differences in knee joint laxity change across the female menstrual cycle","volume":"45","author":"Shultz S.J.","year":"2005","journal-title":"J Sports Med Phys Fitness"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B11.26905"},{"key":"e_1_2_3_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465020300020601"},{"key":"e_1_2_3_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120964884"},{"key":"e_1_2_3_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/19417381231160167"},{"key":"e_1_2_3_16_1","doi-asserted-by":"publisher","DOI":"10.21037\/aoj-22-40"},{"key":"e_1_2_3_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221128828"},{"key":"e_1_2_3_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2019.03.027"},{"key":"e_1_2_3_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519896333"},{"key":"e_1_2_3_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.04.012"},{"key":"e_1_2_3_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-016-3261-9"},{"key":"e_1_2_3_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198003000-00008"},{"key":"e_1_2_3_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221125467"},{"key":"e_1_2_3_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.02.021"},{"key":"e_1_2_3_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2025.01.028"},{"key":"e_1_2_3_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-0160(97)10027-8"},{"key":"e_1_2_3_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-019-0217-1"},{"key":"e_1_2_3_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-019-09529-7"},{"key":"e_1_2_3_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211023099"},{"key":"e_1_2_3_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.11.004"},{"key":"e_1_2_3_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.09.020"},{"key":"e_1_2_3_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.06.007"},{"key":"e_1_2_3_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.07.041"},{"key":"e_1_2_3_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07018-y"},{"key":"e_1_2_3_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518815888"},{"key":"e_1_2_3_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3799-x"},{"key":"e_1_2_3_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671221114820"},{"key":"e_1_2_3_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516652607"},{"key":"e_1_2_3_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.04.028"},{"key":"e_1_2_3_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-012-1718-z"},{"key":"e_1_2_3_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515589166"},{"key":"e_1_2_3_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967119854657"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806325002415?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806325002415?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2025.03.045","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2025.03.045","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2025.03.045","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T09:10:45Z","timestamp":1773565845000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2025.03.045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,1]]},"references-count":41,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1016\/j.arthro.2025.03.045"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2025.03.045","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Lateral Extra-Articular Tenodesis With Iliotibial Band in Anterior Cruciate Ligament Autograft Reconstruction for Female Soccer Athletes With Generalized Ligamentous Laxity Yields Graft Failure and Return-to-Sport Rates Comparable With Athletes Without Generalized Laxity","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2025.03.045","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 by the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}