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The Modified Lemaire Procedure.

Christoph Kittl¹, Michael Wagner², Andreas Weiler²

¹Department of Trauma, Hand and Reconstructive Surgery, Westphalian Wilhelms University Muenster, Muenster, Germany.

Video Journal of Sports Medicine

|May 1, 2025

Summary

This summary is machine-generated.

Adding a lateral extra-articular tenodesis (LET) procedure to anterior cruciate ligament (ACL) reconstruction significantly reduces graft failure. The modified Lemaire procedure is an effective technique for addressing anterolateral rotatory instability (ALRI) and improving ACL reconstruction outcomes.

Keywords:

Lateral extra-articular reconstruction Lemaire reconstruction anterolateral ligament lateral extra-articular tenodesis

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Area of Science:

Orthopedic surgery
Sports medicine
Biomechanics

Background:

Anterolateral rotatory instability (ALRI) is a key factor in anterior cruciate ligament (ACL) reconstruction failure.
An additional reconstruction of anterolateral structures can halve the graft rupture rate.
The modified Lemaire procedure is a lateral extra-articular tenodesis (LET) technique to manage ALRI.

Purpose of the Study:

To detail the modified Lemaire procedure for managing ALRI.
To provide a surgical technique guide for orthopedic surgeons.

Main Methods:

A 7-10 mm strip of the iliotibial tract is harvested from Gerdy's tubercle.
The graft is passed deep to the lateral collateral ligament.
The graft is secured proximal to the lateral femoral epicondyle.

Main Results:

Studies show reduced graft rupture rates and higher return-to-preinjury levels with combined ACL reconstruction and LET.
A trend towards decreased long-term graft rupture rates is observed.
Potential increased risk of lateral compartment osteoarthritis should be considered.

Conclusions:

The modified Lemaire procedure is a straightforward adjunct to ACL reconstruction.
This LET technique effectively lowers the rate of ACL graft failure.