Title : Efficacy of the modified lemaire technique combined with Anterior Cruciate Ligament (ACL) Reconstruction: A comparative analysis with isolated arthroscopic reconstruction
Abstract:
Current Anterior Cruciate Ligament (ACL) reconstruction techniques focus predominantly on intra-articular graft replacement, achieving favorable outcomes in restoring anteroposterior knee stability. However, growing evidence highlights the limitations of this approach in controlling rotational instability, particularly in young, active patients involved in pivoting sports. In these individuals, a higher incidence of persistent rotational laxity is observed, frequently demonstrated by the pivot-shift test, along with non-negligible rates of graft failure.
In this context, the role of the anterolateral complex of the knee in rotational stability is prominent; its deficiency is directly associated with persistent instability even after isolated ACL reconstruction. Therefore, Lateral Extra-articular Tenodesis (LET) emerges as a complementary strategy with the potential to act synergistically with intra-articular reconstruction, enhancing control over tibial rotation and reducing load on the graft.
The incorporation of LET, particularly via the modified Lemaire technique, has been proposed to diminish mechanical graft overload, decrease the prevalence of residual rotational instability, and consequently lower failure rates, especially in high-risk populations. Thus, there is a clear rationale for critically evaluating the benefits of combining these techniques to improve clinical outcomes, enhance graft survival, and optimize a safe return to sports.
