{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:45:05Z","timestamp":1790286305932,"version":"4.1.0"},"reference-count":71,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"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":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anterior cruciate ligament reconstruction augmented with modified-Lemaire lateral extra-articular tenodesis (ACLR+LET) improves rotational stability of the knee in patients with a moderate to high risk of graft failure. Early biomechanical data suggest divergent pullout strengths among various LET fixation methods, but their clinical significance remains to be determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate graft rupture rates in ACLR+LET compared with ACLR alone, stratified by the method of LET femoral fixation.<\/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, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. A comprehensive search was conducted across PubMed, Embase, Scopus, and CENTRAL for studies that referenced\n                      <jats:italic toggle=\"yes\">Lateral Extra-articular Tenodesis<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Modified Lemaire<\/jats:italic>\n                      . A meta-analysis was performed with a significance threshold of .05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 1199 studies were screened, and 17 met the final inclusion criteria. Across these studies, 2527 patients who underwent ACLR were analyzed; 1254 underwent ACLR with LET augmentation. LET augmentation significantly reduced graft rupture rates compared with ACLR alone (odds ratio [OR], 2.90 [95% CI, 1.89-4.46]). Among ACLR+LET subgroups, anchor fixation demonstrated the greatest reduction in graft failure (OR, 4.93;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), followed by staple fixation (OR, 3.04;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Other fixation methods\u2014including button, suture, and screw\u2014showed potential benefit, but individual results were not statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; .05). Further analysis revealed that LET significantly reduced graft failure in primary ACLR (OR, 3.44;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .00). LET-specific hardware removal was rare (0.82% [95% CI, 0.07%-2.10%]), with the highest rates seen in staple fixation, followed by anchor, and no events reported in the button and screw groups (1.58% vs 1.10% vs 0% vs 0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .702).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ACLR+LET significantly reduces the risk of primary graft failure compared with ACLR alone. Among LET femoral fixation methods, anchor and staple fixation demonstrate the lowest ACL graft failure rates, with similar hardware removal rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251405495","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:36:53Z","timestamp":1769161013000},"page":"1471-1478","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Effect of Lateral Extra-articular Tenodesis Femoral Fixation Methods on Graft Failure Rates in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2471-3772","authenticated-orcid":false,"given":"Matthew Charles","family":"Johnson","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York, USA"},{"name":"University of Florida College of Medicine, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameer","family":"Tabbaa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Galina","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hardik","family":"Dabas","sequence":"additional","affiliation":[{"name":"Arkansas College of Osteopathic Medicine, Fort Smith, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orry","family":"Erez","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Chahla","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at RUSH, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Pearle","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Gilat","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York, USA"},{"name":"Sports Injuries Division and Joint Preservation Center, Department of Orthopaedic Surgery, Tel Aviv Medical Center, Tel Aviv, Israel"},{"name":"Gray Faculty of Medical &amp; Health Sciences, Tel-Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"issue":"12","key":"e_1_3_2_2_2","article-title":"Comparison of revision ACL reconstruction using iliotibial band augmented with allograft versus bone-patellar tendon-bone autograft with lateral extra-articular tenodesis","volume":"11","author":"Abou Al","year":"2023","unstructured":"Abou Al, Ezz M, Gerometta A, Valentin E, et al. 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