ACL reconstruction with the over-the-top technique plus lateral extra-articular tenodesis in older versus younger patients

Outcomes and Complication Rates of Anterior Cruciate Ligament Reconstruction Using the "Over-the-top" Technique Combined With Lateral Extra-articular Tenodesis in Patients Over 50 Years Old, Compared With a Control Group of Patients Under 30

Observational Istituto Ortopedico Rizzoli · NCT07041242

This project tests whether ACL reconstruction using the over-the-top technique combined with lateral extra-articular tenodesis gives similar outcomes and complication rates in people over 50 compared with people under 30.

Quick facts

Study typeObservational
Enrollment164 (estimated)
Ages18 Years and up
SexAll
SponsorIstituto Ortopedico Rizzoli Academic / other
Locations1 site (Bologna, Bologna)
Trial IDNCT07041242 on ClinicalTrials.gov

What this trial studies

This is a retrospective observational comparison of patients who underwent ACL reconstruction with autologous gracilis and semitendinosus tendons using the single-bundle over-the-top technique combined with lateral extra-articular tenodesis between 2007 and 2023. Patients are grouped by age at surgery (over 50 versus under 30) and outcomes and complication rates are compared. The study excludes patients with prior or concomitant major knee surgeries, other ligament injuries requiring surgical treatment, surgeries using different techniques, and patients aged 30–50 or under 18. Data are obtained from clinical records and follow-up visits at IRCCS Istituto Ortopedico Rizzoli in Bologna to compare functional outcomes and postoperative complications.

Who should consider this trial

Good fit: Ideal candidates are people who had ACL reconstruction with autologous gracilis and semitendinosus using the over-the-top plus LET technique, were operated on between 2007 and 2023, and were either over 50 or under 30 at the time of surgery with no prior or concurrent major knee surgeries.

Not a fit: Patients aged 30–50, minors, those who had other ligament surgeries or different surgical techniques, or who had prior major knee operations are not represented and likely will not benefit from these findings.

Why it matters

Potential benefit: If outcomes and complication rates are comparable, older patients may be offered this surgical approach more confidently to preserve knee function.

How similar studies have performed: Previous research indicates that adding LET to ACL reconstruction can reduce rotational instability and graft failure in younger or high-risk populations, but its specific performance in patients over 50 has been less studied.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Patients operated on between 2007 and 2023 who were over 50 years old at the time of surgery (study group) and patients under 30 years old at the time of surgery (control group).
* Patients who underwent ACL reconstruction using the gracilis and semitendinosus tendons with the over-the-top + LET technique.
* Patients of both male and female sex.
* Patients who have provided consent to participate in the study.

Exclusion Criteria:

* Previous surgery on the same limb (meniscectomy, prior ACL reconstruction, surgically treated fractures, osteotomies, meniscal transplants).
* Concomitant surgery on the same limb (osteotomies, meniscal transplants).
* Surgical technique different from the over-the-top with LET using autologous gracilis and semitendinosus tendons.
* Other concomitant ligament injuries requiring surgical treatment.
* Patients younger than 18 years at the time of surgery (minors) or patients aged between 30 and 50 years at the time of surgery.
* Patients who have not provided informed consent.
* Patients with a follow-up period shorter than 2 years.

Where this trial is running

Bologna, Bologna

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions ACLLETHamstring Muscles
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.