Browsing by Author "Sandoval , Alfredo"
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Publication Lateral extra-articular tenodesis reduces graft failure without affecting functional outcomes after revision anterior cruciate ligament reconstruction: A retrospective comparative study with 6-year follow-up(2026) Gonzalez, Waldo; Isla, Jorge; Sandoval , Alfredo; Figueroa, Francisco; Itriago, Minerva; Figueroa, DavidIntroduction: Revision anterior cruciate ligament reconstruction (ACLR) is associated with a substantially higher risk of anterior cruciate ligament (ACL) graft failure than primary ACLR. Lateral extra-articular tenodesis (LET) has gained increasing attention as an adjunctive procedure to enhance rotatory stability and potentially reduce the rate of ACL graft failure. The purpose of this study was to compare clinical and functional outcomes between patients undergoing isolated revision ACLR and those undergoing revision ACLR with concomitant LET. We hypothesized that the addition of LET would reduce the incidence of ACL graft failure without compromising functional outcomes or return-to-sport rates. Methods: This retrospective cohort study included skeletally mature patients who underwent first-time revision ACLR with a minimum follow-up of four years. Patients were divided into two groups according to surgical technique: isolated revision ACLR (n = 58) and revision ACLR with LET (n = 65). ACL graft failure was defined as clinically confirmed graft rupture based on a positive pivot-shift or Lachman test, magnetic resonance imaging, or the need for further revision ACLR. Demographic characteristics, surgical details, and patient-reported outcomes (International Knee Documentation Committee [IKDC] and Tegner activity scale) were compared between groups. Results: A total of 123 patients were analyzed (mean age: 27.1 ± 8.0 years) with a mean follow-up of 6.0 years (range: 4.5-7.3 years). Functional outcomes were comparable between groups (IKDC score: 80.4 ± 9.2 vs 84.1 ± 8.8; p = 0.86; Tegner score: 6.6 ± 1.3 vs 6.7 ± 1.2; p = 0.92). ACL graft failure occurred in 11 patients (18.3%) in the isolated revision ACLR group and in 2 patients (3.3%) in the revision ACLR with LET group (p = 0.03; odds ratio: 0.15; 95% confidence interval: 0.03-0.72). Sixty percent of all patients (74/123) returned to sport, including 50 (40.6%) who reached their preinjury level, with no statistically significant differences between groups (p = 0.41). Conclusion: The addition of an LET to revision ACLR significantly reduced the rate of ACL graft failure without adversely affecting functional recovery or return-to-sport rates. This procedure may serve as a valuable adjunct for selected high-risk patients undergoing revision ACLR