ACL Reconstruction with LET Surgeon
If you’re considering ACL reconstruction with LET, Dr. Benedict Nwachukwu can evaluate your knee, activity level, and risk factors to determine whether adding LET may provide additional stability and help reduce the risk of reinjury. Dr. Nwachukwu provides diagnosis and can help you decide the best options for your ACL reconstruction, especially if you are an athlete or a very active individual. He treats patients in Manhattan, and New York City, NY. Contact Dr. Nwachukwu’s team today!
Lateral Extra-Articular Tenodesis (LET): Why It’s Changing the Way We Treat ACL Tears
Adding LET to ACL Reconstruction May Help Reduce the Risk of Reinjury
An ACL tear is one of the most common knee injuries among athletes and active adults. The gold-standard for repair has always been an ACL reconstruction and has proven to be highly successful. However, we have learned that some patients remain at a greater risk of re-injury-even after a technically successful operation.
Why are high-level athletes at risk for an ACL retear?
Recent research has changed the way sports medicine surgeons approach high-level athletes with a torn ACL. For selected patients, we have found that adding a procedure called lateral extra-articular tenodesis (LET) to ACL reconstruction may provide additional stability and help reduce the risk of a future ACL graft tear.
For patients in Manhattan, New York City and the surrounding New York boroughs, Dr. Benedict Nwachukwu uses the latest evidence-based techniques to personalize ACL treatment based on each patient’s injury, anatomy, sport, and long-term goals.
Why More Surgeons Are Adding LET to ACL Reconstruction:
Not every ACL injury is the same. Over the last several years, research has shown that athletes who participate in sports involving cutting, pivoting, and jumping place tremendous rotational forces on the knee. In some patients, those forces can increase the risk of stretching or re-tearing an ACL graft after surgery.
LET was developed to address that problem. Rather than just replacing the ACL, LET serves as an additional stabilizing procedure that helps control rotational movement of the knee. When combined with ACL reconstruction in carefully selected patients, it may reduce stress on the reconstructed ligament during high-demand athletic activities.
What Is Lateral Extra-Articular Tenodesis (LET)?
LET is performed at the same time as ACL reconstruction. During the procedure, a small strip of the iliotibial band (IT band that is found along the lateral side of the leg) is used to reinforce the outside of the knee. This added support helps control rotational movement that can place excessive strain on the reconstructed ACL during cutting, pivoting, and twisting motions. Because LET works alongside the reconstructed ACL, it is considered an adjunct procedure, not a replacement for ACL reconstruction.
ACL Reconstruction with LET
ACL reconstruction restores stability within the knee joint, while lateral extra-articular tenodesis (LET) provides additional support on the outside of the knee to help control rotational instability.
Lateral Extra-Articular Tenodesis (LET)
LET uses a strip of tissue along the outside of the knee to provide additional rotational stability and reinforce the reconstructed ACL.
ACL Reconstruction + LET
Together, ACL reconstruction and LET address both anterior and rotational knee instability. In appropriately selected patients, adding LET may help reduce the risk of ACL graft failure and recurrent instability.
*AI-generated medical illustrations are for informational purposes only and may not be anatomically precise.
Who should have an LET along with ACL Reconstruction?
Most patients achieve excellent results with ACL reconstruction alone. However, LET may be recommended for patients who have a greater risk of reinjury. These groups may include:
- Young athletes returning to competitive sports
- Patients participating in soccer, basketball, football, lacrosse, or skiing
- Individuals with generalized ligament laxity (“loose joints”)
- Patients undergoing revision ACL reconstruction
- Athletes with significant rotational instability of the knee
Determining whether LET is appropriate requires a careful evaluation by an experienced orthopedic sports medicine specialist like Dr. Nwachukwu.
What Are the Benefits of Adding LET?
The goal of LET isn’t simply to perform an additional procedure, it’s to improve long-term outcomes for patients whose knees may benefit from added stability. For the right patient, combining LET with ACL reconstruction may provide several advantages:
- Lower risk of ACL graft failure
- Improved knee control during cutting and pivoting activities
- Increased confidence when returning to sports
- Better protection for high-risk athletes
- Greater long-term knee stability
What Does the Research Show about LET combined with ACL Reconstruction?
Interest in LET has increased because of growing evidence supporting its use in carefully selected patients. Clinical studies have shown that combining ACL reconstruction with LET can significantly reduce graft failure rates in young athletes and others at high risk for reinjury. Researchers have also reported improved rotational stability compared with ACL reconstruction alone. These findings have led many orthopedic sports medicine surgeons like Dr. Nwachukwu to incorporate LET into ACL surgery for patients whose activity level or anatomy places them at greater risk of another ACL injury.
Is the recovery longer after ACL Reconstruction with LET?
Not usually. Recovery after LET generally follows the same physical therapy rehabilitation program as standard ACL reconstruction. Physical therapy begins soon after surgery and progresses through several stages, including restoring motion, rebuilding strength, and improving balance. Eventually, patients in Manhattan, New York City and surrounding New York boroughs are able to return to sport-specific activities. Throughout rehabilitation, the focus is on helping patients regain confidence in their knee while safely returning to the activities they enjoy.
Dr Nwachukwu suggests an individualized physical therapy program which is based on the patient’s progress, goals, and the demands of their sport.
Why Choose Dr. Benedict Nwachukwu?
Successful ACL surgery isn’t just about reconstructing a ligament, it’s about choosing the right procedure for the right patient. Dr. Benedict Nwachukwu specializes in ACL reconstruction, complex knee ligament injuries, and sports medicine. By combining advanced surgical techniques with the latest orthopedic research, he develops individualized treatment plans designed to restore knee stability, protect long-term joint health, and help patients return to the activities they love.
What is the science behind LET with an ACL Reconstruction?
Dr. Nwachukuw was an author on the following study/poster.
You can read the information here:
FAQs (Frequently Asked Questions)
Schedule a Consultation with an ACL Reconstruction Specialist in Manhattan
If you’ve torn your ACL or are considering ACL surgery, it’s important to understand all of your treatment options. Dr. Benedict Nwachukwu specializes in advanced ACL reconstruction and evidence-based techniques, including lateral extra-articular tenodesis (LET) for patients who may benefit from additional knee stability. Schedule a consultation to learn which treatment is best suited to your injury and your return-to-sport goals.
