The addition of lateral extraarticular tenodesis does not significantly affect the pain or confidence levels after anterior cruciate ligament reconstruction in adolescent athletes.

Anterior cruciate ligament reconstruction (ACLR) in adolescents is associated with high reinjury rates, leading to increasing use of lateral extra-articular tenodesis (LET).While LET reduces graft failure, its effect on pain and psychological readiness for return to sport in adolescents remains unclear.This retrospective matched-cohort study evaluated whether LET influences short-term patient-reported outcomes following ACLR.A total of 238 adolescents undergoing primary hamstring autograft ACLR were included, with 79 receiving additional LET and 159 undergoing isolated ACLR.Groups were matched 1:2 for age, sex, BMI, graft type and fixation.Validated patient-reported outcome measures (IKDC, Lysholm, Tegner and ACL-RSI) were collected pre-operatively and post-operatively.Changes in outcomes were compared between groups using non-parametric analysis.Both cohorts demonstrated significant improvements in knee function, activity level and pain at 9 months.There were no statistically significant differences between LET and no-LET groups in improvements in IKDC, Lysholm, Tegner or IKDC pain scores.Psychological readiness, measured by ACL-RSI, showed a non-significant trend favouring LET but was comparable overall.These findings suggest that LET does not adversely affect short-term pain or confidence following adolescent ACLR.The role of LET appears biomechanical rather than contributory to early subjective recovery, supporting its selective use in high-risk patients.