ArticleArchives of orthopaedic and trauma surgery2026
Two-year outcomes following concomitant ACL and extra-articular ligament reconstruction: a nationwide analysis of over 5,000 patients.
Article in Archives of orthopaedic and trauma surgery, 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
purposeThe anterior cruciate ligament (ACL) is the most commonly injured and reconstruction ligament in the United States. Associated injuries are common, oftentimes including components of the extra-articular knee. However, complications following concomitant ACL and extra-articular ligaments (EAL) has not been defined in a large-scale, population-based sample. We aimed to analyze outcomes following concomitant ACL and EAL reconstruction using the TriNetX nationwide database.ep
methodsDeidentified data from the TriNetX Collaborative Network was used to identify all patients who received ACL and EAL reconstruction on the same day. Demographic information including age, sex, race, and geographic data were collected. Rates of medical and orthopaedic complications were analyzed at 30, 90, and 180 days and at 2 years. A propensity matched sub-analysis comparing outcomes patients with concomitant and staged repair was performed. Patients were identified using Current Procedural Terminology (CPT) coding.
resultsWe identified 5944 patients who received concomitant ACL and EAL reconstruction with postoperative outcomes available at 30, 90, and 180 days. 5040 patients had data available at 2 years. Serious medical complications like surgical site infection, deep vein thrombosis, acute kidney failure, and sepsis were rare at each point of follow-up. Rates of revision surgery were low at short-term follow-up but were prevalent for both procedures at 2 years (> 2%). The most common orthopaedic complications osteoarthritis, implant/graft failure, and knee instability. However, these incidences remained below 7.5% at each interval. Outcomes were similar for staged and concomitant reconstruction, but osteoarthritis, implant/graft failure, and knee instability were significantly more common in the former group at various points.
conclusionsConcomitant ACL and EAL reconstruction demonstrated negligible rates of serious medical complications. While rates of osteoarthritis, instability, and graft failure increased at each point, these were generally comparable to independent ACL and EAL procedures. While there was little difference in outcomes between staged and concomitant reconstruction, the latter should be preferred due to lower rates of osteoarthritis, graft failure, and instability. LEVEL OF EVIDENCE: Level III.
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