Mid-term outcomes after isolated bone-patellar tendon-bone ACL reconstruction versus hamstring ACL reconstruction combined with lateral extra-articular tenodesis in competitive soccer players: A prospective comparative study.

At mid-term follow-up, HT + LET did not demonstrate statistically significant superiority over isolated bone-patellar tendon-bone ACL reconstruction in clinical outcomes, knee stability, return to sport, graft survival, reoperation, or radiographic osteoarthritis among competitive soccer players.

As this was not an equivalence or non-inferiority study, smaller clinically relevant differences cannot be excluded.

These findings should be interpreted as a comparison of two surgical strategies, rather than as evidence of the independent effect of LET.