Lateral Extra-Articular Tenodesis (LET) has become an accepted adjunct to standard anterior cruciate ligament reconstruction to help provide additional rotational stability to the knee and lower the risk of re-tears. The classic situation to perform this surgery would be at the same time as an ACL reconstruction in a patient with a high degree of rotational instability or in a patient who has already had ACL surgery and re-torn. However, might there be a role for LET performed as a standalone procedure? A subset of patients following ACL surgery will have a knee that is very stable in the anterior-to-posterior (front-to-back) direction but continues to demonstrate some degree of rotational instability. Could an LET performed in isolation provide these patients with that additional rotational stability and thus lower their risk of another injury, or is that a crazy idea?
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