Abstract Purpose This study aimed to compare occupational and clinical outcomes, including return‐to‐work (RTW) metrics, graft failure rates, complications and functional outcomes using patient‐reported outcome measures (PROMs), in workers' compensation patients undergoing revision anterior cruciate ligament (ACL) reconstruction with or without the addition of a lateral extra‐articular procedure (LEAP). Methods A retrospective cohort study was conducted on workers over 18 years old who underwent first‐time revision ACL reconstruction, with or without LEAP, between January 2016 and December 2022, with a minimum follow‐up of 2 years. All graft types and LEAP techniques were included, as well as associated meniscal procedures. Outcomes assessed included workload classification according to the REFA (Reichsausschuss für Arbeitszeitermittlung) system, RTW rate and time to RTW, graft re‐rupture, complications and PROMs (Lysholm and Knee Osteoarthritis Outcome Score KOOS). Functional outcomes were evaluated only in patients without graft failure. Statistical analyses included t ‐tests, Mann–Whitney U ‐tests and chi‐square tests. Results Sixty‐four patients met the inclusion criteria (30 non‐LEAP, 34 LEAP). RTW to the same work duties was comparable between groups (70% vs. 85.2%, p = 0.14); however, time to RTW was significantly shorter in the LEAP group (167.8 ± 80.9 vs. 291.5 ± 183.6 days; p < 0.001). The graft re‐rupture rate was significantly lower with LEAP (5.9% vs. 33.3%; p = 0.005). PROMs showed no significant differences between groups in Lysholm or KOOS scores. Complication rates were low and comparable (six events in each group; p = 0.810), with no LEAP‐related increase. Conclusions In workers' compensation patients undergoing revision ACL reconstruction, adding a LEAP significantly accelerates RTW and reduces graft failure without increasing complications, supporting its role as a valuable adjunct in this population. Level of Evidence Level III, retrospective cohort study.
Olivieri et al. (Sat,) studied this question.