{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T05:43:50Z","timestamp":1789278230003,"version":"build-2803163510"},"reference-count":58,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although anterior cruciate ligament (ACL) reconstruction (ACLR) remains the standard to treat ACL ruptures, athletes remain at higher risk of graft rerupture. Concomitant lateral extra-articular tenodesis (LET) has gained popularity by improving rotatory stability, yet no synthesis of expected return-to-sport (RTS) rates in athletes undergoing ACLR with LET (ACLR+LET) exists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purposes:<\/jats:title>\n                    <jats:p>To synthesize RTS outcomes in athletes undergoing ACLR+LET and compare RTS rates, patient-reported outcome measures, and adverse event rates between isolated ACLR (iACLR) and ACLR+LET in the athletic population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis; Level of evidence 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Studies reporting RTS after primary single-bundle iACLR and ACLR+LET using an iliotibial band autograft at a minimum 12-month clinical follow-up were included. Primary outcomes were RTS and return to previous level (RTPL), while secondary outcomes were patient-reported outcomes and adverse events. Study quality was assessed using the Cochrane Risk of Bias 2 and Methodological Index for Non-Randomized Studies tools, while RTS criteria were assessed using the Return to Play Quality of Evidence tool. Meta-analyses and sensitivity analyses were performed using R with the \u201cMetafor\u201d package.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fourteen studies were included, encompassing 1791 patients (38% female; mean age, 23.5 \u00b1 8.5 years); 840 patients (709 athletes) underwent iACLR and 951 patients (901 athletes) underwent ACLR+LET. Grafts, surgical techniques, and rehabilitation protocols varied, and athletes participated in a variety of competitive and noncompetitive sports. Patients with iACLR reported a mean overall RTS rate of 88.2% \u00b1 1.8% (344\/390) and mean RTPL rate of 79% \u00b1 16.2% (264\/334), while patients with ACLR+LET reported a mean RTS rate of 88.2% \u00b1 10.4% (591\/670) and RTPL rate of 76.9% \u00b1 16.5% (333\/433). RTS did not significantly differ between the iACLR and ACLR+LET groups (OR, 0.84; 95% CI, 0.55-1.27;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .41), nor did RTPL (OR, 1.20; 95% CI, 0.78-1.84;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .40). Patients with ACLR+LET reported superior side-to-side laxity and flexion differential (both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and reduced graft rerupture risk (OR, 0.31; 95% CI, 0.17-0.57;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is no significant difference in RTS rates between the iACLR and ACLR+LET groups. However, ACLR+LET is associated with superior rotational stability and significantly lower graft rupture risk in an athletic population, supporting its use in high-risk patients where durability is critical.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251386013","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:00:45Z","timestamp":1768204845000},"page":"1215-1225","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["No Significant Difference in Return-to-Sport Rates Between Anterior Cruciate Ligament Reconstruction With Lateral Extra-Articular Tenodesis and Isolated Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4933-9375","authenticated-orcid":false,"given":"Viraj A.","family":"Deshpande","sequence":"first","affiliation":[{"name":"Department of Education and Research, Hoag Orthopedics, Irvine, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Education and Research, Hoag Orthopedics, Irvine, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Barnett","sequence":"additional","affiliation":[{"name":"Department of Education and Research, Hoag Orthopedics, Irvine, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Frausto","sequence":"additional","affiliation":[{"name":"Department of Education and Research, Hoag Orthopedics, Irvine, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Saunders","sequence":"additional","affiliation":[{"name":"Department of Education and Research, Hoag Orthopedics, Irvine, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Gazzaniga","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hoag Orthopedic Institute, Irvine, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin C.","family":"Parvaresh","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hoag Orthopedic Institute, Irvine, California, 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