PURPOSE: To investigate the patient reported outcome measures (PROMs) and graft survival of combined anterior cruciate ligament reconstruction and lateral extra-articular tenodesis (ACLR-LET) compared with a matched cohort having ACLR alone. METHODS: Patients were retrospectively recruited from a consecutive series of primary ACLR-LET, between 1996-2015, with a minimum post-surgical time of four years. ACLR-LET were matched with isolated ACLR for age, gender and operation year. The indications for adding LET were lateral laxity of grade 1 or 2, hyperextension laxity and/or increased rotational laxity of 5 - 10°. The technique used involved detaching a strip of ilio-tibial band proximally, before being passed deep to the lateral collateral ligament, looped through Kaplan's fibres and sutured back onto itself at physiological tension. PROMs used were the Lysholm Knee Scoring Scale (LKS), Tegner Activity Scale (TAS), Oxford Knee Score (OKS) and International Knee Documentation Committee (IKDC) subjective knee form. Failure was defined as graft rupture. Student's t-test was used to compare the matched groups and Kaplan Meier analysis for survivorship. RESULTS: 83patients had ACLR-LET between 1996-2015. 9revision cases and 2with less than 4years follow-up were excluded. The remaining 72ACLR-LET patients were matched and included in the survival analysis. 70% of patients completed the PROMs. In both groups, 76% were males and the mean age was 25years(standard deviation±8.5). The median follow-up was 10years (Interquartile range 6.7years). There was no significant change of PROMs (LKS:P=.82, 95%Confidence interval (CI), -13 to 11; IKDC:P=0.07, CI -1 to 24; OKS:P=.5, CI -8 to 4; TAS:P=.5, CI -1 to 3) between the groups. The pre- to post-operative PROMs, except the TAS, improved significantly, clinically and statistically. There was no statistically significant difference in graft failure between the ACLR-LET group(n=4, 5%) and the ACLR group(n=9, 11%) (log-rank P=.099). CONCLUSION: ACLR-LET shows good graft survival and PROMs in a high-risk population. This suggests that LET is an effective technique to restore joint stability to a knee with additional features of laxity.