2026 COA Annual Meeting: Lateral Extra-Articular Tenodesis with Anterior Cruciate Ligament Reconstruction in Pediatric and Skeletally Immature Patients is Safe and Yields Low Rates of Re-Rupture

9 studies involving 317 patients (318 knees) were included in this systematic review and meta-analysis evaluating lateral extra-articular tenodesis (LET) as an additional treatment to anterior cruciate ligament reconstruction (ACLR) in pediatric and skeletally immature patients. Pooled outcomes included graft re-rupture rates, return to sport, patient-reported outcome measures, complications, and growth disturbances. Overall, compared with isolated ACLR, ACLR+LET was associated with significantly lower graft re-rupture rates and significantly higher RTS rates. These findings suggest that LET is a safe treatment to ACLR in young patients and may improve graft survivorship while maintaining excellent rates of return to sport.