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Rates of Arthrofibrosis in Adolescent Patients After ACL Reconstruction Using Hamstring Autograft With or Without
Christopher J DeFrancesco1,2, Emma Cavendish3, Mininder S Kocher4,5
1Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
The American Journal of Sports Medicine
|January 1, 2026
Summary
Adding lateral extra-articular tenodesis (LET) to anterior cruciate ligament (ACL) reconstruction in adolescents did not increase the risk of arthrofibrosis. This study found similar arthrofibrosis rates in patients with and without LET after hamstring autograft ACL surgery.
Area of Science:
- Orthopedic surgery
- Sports medicine
- Biomechanical engineering
Background:
- Anterior cruciate ligament (ACL) reconstruction is a common procedure in adolescents.
- Lateral extra-articular tenodesis (LET) is an adjunct procedure to ACL reconstruction aimed at reducing graft failure.
- The impact of LET on postoperative complications like arthrofibrosis in adolescent hamstring autograft ACL reconstruction remains unclear.
Purpose of the Study:
- To determine if the addition of modified Lemaire lateral extra-articular tenodesis (LET) to anterior cruciate ligament (ACL) reconstruction using hamstring autograft increases the risk of arthrofibrosis in adolescent patients.
- To compare the rates of arthrofibrosis between adolescent patients undergoing ACL reconstruction with and without LET.
Main Methods:
- Retrospective cohort study including 569 patients aged 10-19 years who underwent hamstring autograft ACL reconstruction.
- Data collected included patient demographics, surgical variables (meniscal repair/meniscectomy, LET inclusion, drilling method), and complications requiring return to operating room (RTOR).
- Arthrofibrosis was defined as a range of motion deficit requiring lysis of adhesions and manipulation under anesthesia within one year of surgery.
Main Results:
- A total of 569 cases were analyzed.
- The rate of arthrofibrosis was 1.2% in patients who underwent ACL reconstruction with LET compared to 3.7% in those without LET (P = .34).
- The addition of LET did not significantly increase the risk of arthrofibrosis.
Conclusions:
- The rate of arthrofibrosis requiring surgical intervention after hamstring ACL reconstruction in adolescents is low.
- The inclusion of lateral extra-articular tenodesis (LET) in conjunction with hamstring autograft ACL reconstruction does not appear to elevate the risk of arthrofibrosis in this adolescent population.
- LET can be considered as an adjunct procedure without a significant increase in arthrofibrosis risk.
