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Purpose: This study aimed to compare the short-term outcomes of ACL reconstruction (ACLR) alone, ACLR with lateral tenodesis, and ACL and ALL reconstruction. Methods: A retrospective cohort of prospectively collected data on all ACL procedures was performed at Aspetar Specialized Orthopaedic and Sports Medicine Hospital between January 2020 and January 2021. Patients were treated with ACLR alone, ACLR with lateral tenodesis, or ACLR with ALL reconstruction. The primary outcome was the subjective International Knee Documentation Committee (sIKDC) score. The secondary outcomes were the ACL Return to Sport after Injury (ACL-RSI) scores, pivot shift grade, subjective knee stability, and subjective pain on activity. Results: A total of 100 cases were included. The most common technique was ACLR with lateral tenodesis (42%), followed by ACLR alone (38%) and ACL with ALL reconstruction (20%). The mean age was 28.15 years (15–60), and 94% of the patients were males. Meniscal procedures were more frequent in the ACLR alone group (65.8%). There was no association between subjective stability, sIKDC, ACL-RSI, and pivot shift grade and the three ACLR techniques while adjusting for age, sex, and concomitant meniscus procedures at six weeks, 12 weeks, six months, and nine months. However, there was a significant decrease in postoperative flexion in the ACL and ALL reconstruction group by a mean of 22° (95% CI − 40.7 − 3.4; P = 0.02) at 6 weeks compared to ACLR alone, which was not evident on later follow-ups. Conclusion: ACLR with/without lateral augmentation procedures yields similar subjective IKDC, ACL-RSI, pivot shift grade, and subjective knee instability at short-term follow-up. Therefore, lateral extra-articular augmentation procedures are safe to be performed. [ABSTRACT FROM AUTHOR]

This document is a response to a letter to the editor regarding a study on anterior cruciate ligament (ACL) reconstruction. The authors address various points raised in the letter, including the allocation of patients to different surgeons, the correlation between meniscal procedures and pain scores, the reporting of ACL-RSI scores, the focus on short-term outcomes rather than return to play, and the use of allografts in ACL reconstruction. The authors emphasize the importance of aligning surgical procedures with surgeons' knowledge and experience and acknowledge the limitations of their study. They also express gratitude for the peer review process and declare no competing interests. [Extracted from the article]