Projects

Anterior cruciate ligament (ACL) reconstructions together with lateral extra-articular tenodesis (LET), or
LET procedures alone, were frequently used to treat ACL tears with anterolateral instability. The choice of
the LET procedure is still debated because each technique varies in terms of graft selection and fixation.
Therefore, the aim of our study was to compare the functional outcome of the two commonly used lateral
extra-articular tenodesis procedures, modified Lemaire and modified Andrews techniques, in combination
with ACL reconstruction.
Methods
Fifty patients with ACL tears and anterolateral instability were split into two groups (25 each) for this
prospective comparative study. Patients in the first group received treatment using the modified Lemaire
technique of lateral extra-articular tenodesis, while patients in the second group received treatment using
the modified Andrews technique of lateral extra-articular tenodesis. For both groups, ACL reconstruction
was done by the standard transportal technique using a soft tissue graft. Patients of both groups were then
evaluated using the Lysholm Knee score at pre-op, six months, and one year post-operative follow-up.
Results
The average age in this study was 31.88 years, consisting of 20 male patients (80%) and five female patients
(20%) in the modified Andrews LET group. In the modified Lemaire’s LET group, the average age was 28.92
years, comprising 17 male patients (68%) and 8 female patients (32%). The pre-operative mean Lysholm
score for the modified Andrews group was 65.2 +/- 4.72. The post-operative mean Lysholm scores at six
months and one year were 86.2 +/- 6.1 and 95.1 +/- 3.58, respectively. The pre-operative mean Lysholm score
for the modified Lemaire group was 63.9 +/-2.89. The post-operative mean Lysholm scores at six months and
one year were 84.2 +/-7.42 and 94.5 +/- 6.4, respectively. Our study found no statistically significant
difference in the Lysholm score between the two groups.
Conclusion
Various LET procedures have been employed to improve ACL reconstruction due to their ability to offer
secondary restraint. They also diminish the stress encountered by the intra-articular reconstruction
grafts. Consequently, in patients requiring additional safeguarding for the intra-articular graft, including
those who are obese, athletes, or possess markedly compromised anterolateral tissues, the incorporation of a
LET into an ACL reconstruction may be viable. The selection of the LET procedure, whether modified
Lemaire's technique or modified Andrews technique, may be determined at the surgeon's discretion, as both
techniques yield comparable functional outcomes according to our study.

anterior cruciate ligament (acl), arthroscopic acl reconstruction, lateral extra articular tenodesis, modified
andrews technique, modified lemaire's technique