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The goal of extra-articular augmentation or reconstruction is to eliminate residual laxity and reduce the risk of ACL graft rupture. Illiotibial band tenodesis or anterolateral ligament reconstruction could play a role in augmenting rotational stability in the ACL-reconstructed knee.

These procedures are most likely to benefit hyperlax patients, revision cases, pivoting athletes, and those with IKDC grade III pivot shifts.

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