Does Adding Lateral Extra-Articular Tenodesis Improve Outcomes After Arthroscopic Anterior Cruciate Ligament Reconstruction? A Longitudinal Comparative Study.

Introduction: Residual rotational instability may persist after isolated anterior cruciate ligament reconstruction (ACLR). Lateral extra-articular tenodesis (LET) has re-emerged as an adjunct procedure to improve rotational stability. We present a Longitudinal Comparative Study comparing functional outcomes of ACLR performed with and without LET. Materials and Methods: Forty patients with ACL injury were treated surgically between 2022 and 2024. Twenty patients underwent isolated ACLR (Group B) and 20 underwent ACLR combined with LET (Group A). Functional outcomes were assessed using the Knee Society Score (KSS), clinical stability tests, return-to-sport status, and complication profiles over an 18-month follow-up period. Results: Both groups demonstrated significant functional improvement. Group A achieved higher KSS at all follow-up intervals. A negative pivot-shift test was observed in 95% of Group A compared with 70% of Group B. Return to pre-injury sports was higher in Group A (75% vs. 50%). Complication rates and range of motion recovery were comparable. Conclusion: The addition of LET to ACLR improves rotational stability and functional recovery without increasing complications. Combined reconstruction may be advantageous in patients at risk of persistent instability.