ArticleThe American journal of sports medicine2026
Short-term Patient-Reported Outcomes After Primary Anterior Cruciate Ligament Reconstruction With and Without Lateral Extra-articular Tenodesis: A Matched-Cohort Analysis From the Swedish Knee Ligament Registry.
Article in The American journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDespite reduced graft failure rates reported in randomized controlled trials comparing anterior cruciate ligament reconstruction (ACL-R) with and without lateral extra-articular tenodesis (LET), the impact of LET on postoperative patient-reported outcomes (PROs) remains poorly defined. PURPOSE: To compare short-term PROs, as well as anterior cruciate ligament (ACL) revision rates and clinical failure rates (defined as Knee injury and Osteoarthritis Outcome Score [KOOS] Quality of Life [QoL] value <44) between patients undergoing primary ACL-R with and without concomitant LET. STUDY
designCohort study; Level of evidence, 3.
methodsData were extracted from the Swedish Knee Ligament Registry for all patients undergoing primary ACL-R between January 1, 2005, and June 25, 2025. Patients who underwent ACL-R + LET were matched to patients who underwent ACL-R without LET using 1:4 matching based on age, sex, body mass index, graft type, time from injury to reconstruction, and concomitant meniscal and cartilage injury status. The primary outcomes were KOOS values at the 1- and 2-year follow-ups.Secondary outcomes included revision ACL-R and clinical failure within 1 and 2 years. Categorical variables were compared using Fisher exact or chi-square tests, continuous variables were compared using Fisher nonparametric permutation tests, and within-group KOOS changes were compared using Wilcoxon signed-rank tests. Adjusted 1- and 2-year KOOS Symptoms comparisons for baseline differences and outcomes were interpreted relative to published minimal clinically important difference thresholds.
resultsAfter matching, the final cohort consisted of 870 patients: 174 in the ACL-R + LET group and 696 in the ACL-R group. There were no significant between-group differences in KOOS
conclusionIn this matched-cohort registry study, the addition of LET to primary ACL-R did not demonstrate superior short-term PROs at 1 or 2 years postsurgery.
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