Anterior Cruciate Ligament (ACL) Tears: Lateral Extra-Articular Tenodesis (LET) Animation

Anterior Cruciate Ligament (ACL) Tears: Lateral Extra-Articular Tenodesis (LET) Animation

This animation demonstrates a lateral extra-articular tenodesis, or LET procedure. This procedure involves cutting and repositioning part of the iliotibial, or IT band, at the outer side of the knee. It is completed in addition to an anterior cruciate ligament reconstruction to reinforce the stability of the knee joint following surgery.

Here we see the outer side of a left knee. Here is the thigh bone, or femur, here is the shinbone, or tibia, and here is the IT band. A skin incision is made over the IT band. While remaining attached to the shinbone, a section of the IT band is cut away, and a suture is attached to the free end.

The lateral collateral ligament, or LCL, is identified. An angled clamp is passed underneath the LCL, and the suture is placed into the clamp. The clamp is pulled to pass the suture and IT band graft underneath the LCL.

Next, the thigh bone is prepared for a bone anchor. A hole for the anchor can be made with a punch, a drill, or a self-punching anchor. The anchor is melted into the bone, and the guide is removed. The anchor is already threaded with sutures with loops in place.

The graft is passed through both loops of the anchor. The knee is partially straightened and one of the sutures is pulled to bring the graft tight to the bone. The graft is passed back through the other loop, which is pulled to tighten the graft once again. The sutures and the graft are cut.

The skin incisions will be closed with sutures, and the procedure is complete.