Editorial Commentary: LET's Keep Expanding Our Indications for Lateral Extra-articular Procedures During Anterior Cruciate Ligament Reconstruction.

Anatomic anterior cruciate ligament reconstruction has been successful for many years in restoring translational stability, but have we done enough to restore rotational stability? Biomechanical evidence shows that anatomic anterior cruciate ligament reconstruction alone may not restore pivot shift stability in cadaveric models. When added to anatomic anterior cruciate ligament reconstruction, lateral extra-articular tenodesis can restore pivot shift stability, even in the context of lateral meniscus root tears, increased tibial slope, tibial bone loss, and medial meniscectomy. Clinical studies (while not uniformly positive) have shown promise in reducing graft failure rates without increased risks of complications. Let's us keep pushing the indications for lateral extra-articular tenodesis while keeping track of short- and long-term outcomes-benefits continue to be shown clinically and biomechanically, while the negative impact is low.