Krebs NM, et al. - This study was sought to evaluate patients with generalized joint laxity (GJL) after primary anterior cruciate ligament (ACL) reconstruction (ACLR) as to the risk of ACLR failure, graft selection success rates, and overall clinical outcomes. Researchers conducted a systematic review of the PubMed and EMBASE databases to distinguish studies published from the inception of the databases through February 4, 2020. They enrolled nine studies including a total of 1,869 patients. After primary ACLR, patients with GJL are at an increased risk of inferior outcomes and graft failure. In patients with GJL, bone-patellar tendon-bone (BPTB) autografts may have more favorable stability outcomes compared to hamstring autografts. Nevertheless, even with a BPTB autograft, the reported stability parameters and KT outcomes, remain inferior to non-GJL published results and the added benefit of an EA procedure to supplement the primary ACLR deserves consideration.