ACL Reconstruction With LET in Athletes: Randomized Trial Findings

Key Takeaways

• Adding modified Lemaire LET to ACL reconstruction was associated with better Lysholm, IKDC, and KT1000 side-to-side results at 12 months.
• Enrollment was limited to athlete patients younger than 40 years with isolated ACL tear, no meniscal injury or ligamentous laxity, and pivot shift grade 2 or 3.
• Patients were reviewed every 3 months for at least 1 year, two control patients were lost to follow-up and excluded, and no complications were reported aside from one failed control case.

In a randomized trial of 41 athlete patients younger than 40 years, arthroscopic anatomical single-bundle ACL reconstruction plus modified Lemaire LET was compared with ACL reconstruction alone. The study was limited to athlete patients with isolated ACL tears, no meniscal injury or ligamentous laxity, and high-grade pivot shift rather than broader ACL populations. At 12 months, the augmented group had better knee function scores and less side-to-side laxity than reconstruction alone. These one-year findings favored the added extra-articular procedure within this narrowly selected athletic subgroup.

Researchers conducted a randomized controlled clinical trial in athlete patients younger than 40 years with isolated ACL tear only. Eligibility also required no meniscal injury, no ligamentous laxity, and pivot shift grade 2 or 3. This narrowed enrollment to a subgroup with high pivot shift but without other reported meniscal or ligamentous findings. Twenty patients were assigned to arthroscopic anatomical single-bundle ACL reconstruction plus modified Lemaire LET, and 21 were assigned to ACL reconstruction alone. Patients were evaluated every 3 months for at least 1 year, with objective stability and functional knee outcomes assessed during follow-up.

The main outcomes were Lysholm score, IKDC score, and KT1000 side-to-side difference for between-group comparison. At the 12-month assessment, the group receiving modified Lemaire LET had higher Lysholm scores than the reconstruction-alone group. IKDC scores were also higher in the augmented group, and both between-group differences reached statistical significance, with p = 0.011 and p = 0.003. Instrumented laxity also differed, with a smaller KT1000 side-to-side difference in the LET group at 12 months, with p = 0.002. Overall, the one-year results favored the augmented reconstruction group on both patient-reported scores and objective instrumented laxity.

Patients were seen at 3-month intervals through at least 1 year, and follow-up losses occurred only in the ACL reconstruction-alone arm. Two patients in that control group were lost to follow-up and excluded from the statistical analysis set. No complications were reported aside from one failed control case that declined further intervention after failure. Investigators defined failure by persistent pivot shift, and radiologic confirmation was reported. No other adverse events were described, and the reported advantage was limited to this selected athlete subgroup and the 12-month timeframe.