A pivotal meta-analysis confirmed that combining anterior cruciate ligament (ACL) reconstruction with lateral extra-articular tenodesis (LET) significantly improves knee stability and reduces the risk of graft failure in young athletes engaged in pivot-heavy sports. This comprehensive review, analyzing multiple randomized controlled trials (RCTs) with at least two years of follow-up, has sparked renewed interest and evolving practices within the orthopedic and sports medicine communities.
The findings have particular relevance for sports such as football, basketball, soccer, and skiing—disciplines that place high rotational demands on the knee joint. According to the analysis, athletes who underwent both ACL reconstruction and LET experienced markedly fewer incidents of graft rupture and demonstrated superior functional outcomes compared to those who received ACL reconstruction alone.
LET involves reinforcing the lateral side of the knee to better resist rotational forces, offering an additional layer of stability. Historically, this technique was used sporadically, but the recent meta-analysis provides strong evidence to support its routine inclusion in surgical planning for certain patient populations—especially young, high-risk athletes. The enhanced stability conferred by the LET procedure is seen as a valuable tool in preventing repeat injuries, which are notoriously common in young athletes returning to competition post-ACL surgery.
As a result, sports medicine teams across various professional and collegiate levels are beginning to reevaluate their injury management protocols. Many are now integrating LET into their standard surgical approaches or considering it for athletes with specific risk profiles. The implications are far-reaching, with potential for improved long-term joint health, reduced need for revision surgeries, and quicker, safer returns to play.
This development caps a transformative year in knee surgery, marked by parallel advancements in biologic augmentation, minimally invasive techniques, and personalized rehabilitation programs. Together, these innovations are shaping a new era of orthopedic care that prioritizes durability, function, and the holistic recovery of athletes.
Orthopedic surgeons, physical therapists, and sports teams are taking note, as the data continues to build a strong case for the combined ACL+LET approach. Looking ahead, 2024 is expected to bring broader adoption of this technique, alongside ongoing research aimed at refining surgical strategies and optimizing outcomes for active patients of all ages.
