{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:28:35Z","timestamp":1780576115600,"version":"3.54.1"},"reference-count":41,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"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":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is no consensus regarding the appropriate indications for the addition of lateral extra-articular tenodesis (LET) to anterior cruciate ligament (ACL) reconstruction (ACLR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To determine if incomplete correction of the pivot shift during ACLR is an appropriate intraoperative indication to add the LET, in terms of clinical outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>From January 2018, incomplete correction of the pivot shift relative to the contralateral knee was used as the indication to add LET to ACLR. Patients presenting before this date comprised group A and those after group B. Study criteria included first-ever ACL rupture, participating in pivoting sports, no other significant ligament injury, and surgery within 3 months of injury. Outcomes of interest were recurrent instability, meniscal tears, and patient-reported outcome measures (PROMs): Tegner activity score (TAS), Knee injury and Osteoarthritis Outcome Score subscales for sport and recreation (sport\/rec) and knee-related quality of life, subjective International Knee Documentation Committee score, and Lysholm knee score. Statistical analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Group A (2258 patients; 51% male) and group B (2497 patients; 58% male) were similar regarding age, body mass index, knee dominance, time to surgery, graft diameter, and preinjury TAS (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; .05). Group A had a lower male-to-female ratio (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05) and lower posterior tibial slope (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01). After 2 years, group A had a higher incidence of ACL rerupture than group B (101\/2258 [4.5%] vs 75\/2497 [3%];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01), with a significant sex and group interaction (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04). Males in group A (4.4%) had a higher rate of recurrence than males in group B (2.4%) at 2 years (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03), while in females the rate of recurrence was similar (4.5% vs 3.8%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .42). Group A had a higher incidence of experiencing a subsequent ipsilateral meniscal tear (58\/2258 [2.6%] vs 35\/2497 [1.4%];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02). All PROMs were similar (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; .05). Pivot-shift grade before surgery did not correlate with risk of recurrence (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .991). Uncorrected residual pivot shift was associated with a higher ACL graft rupture rate (\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>Using incomplete correction of the pivot shift during ACL surgery as the primary indication to perform LET is associated with lower rates of recurrent ACL rupture, and ipsilateral meniscal tears. Pivot-shift grade before surgery was not associated with risk of recurrence, while residual pivot shift after surgery was.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251399208","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T07:16:38Z","timestamp":1768634198000},"page":"248-256","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Using a Residual Pivot Shift as the Indication to Perform a Lateral Extra-articular Tenodesis During ACL Reconstruction Using Autologous Hamstring Grafts Is Associated With Improved Surgical Outcomes: A Retrospective Review of 4755 Cases"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5542-794X","authenticated-orcid":false,"given":"Mark","family":"Porter","sequence":"first","affiliation":[{"name":"Canberra Orthopaedics and Sports Medicine, Canberra, ACT, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Shadbolt","sequence":"additional","affiliation":[{"name":"Western Sydney University, School of Medicine, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505280214"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1860-y"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231198494"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508330143"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508330149"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546521994467"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117731767"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198003000-00008"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967118777823"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517745268"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519896333"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231173698"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516674477"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2024.12.007"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1850-0"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-0711-3"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671241230967"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515614312"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503261722"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200812000-00001"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231180859"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508328114"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520956302"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000365"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.26603\/001c.94015"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519831686"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2022.11.013"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211023099"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516682233"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.01412"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514562751"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514549938"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967116665795"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/ans.17795"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520910148"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517750123"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.1998.28.2.88"},{"issue":"9","key":"e_1_3_2_39_2","first-page":"689","article-title":"Accuracy of physical diagnostic tests for assessing ruptures of the anterior cruciate ligament: a meta-analysis","volume":"52","author":"Scholten RJ","year":"2003","unstructured":"Scholten RJ, Opstelten W, van der Plas CG, et al. 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