Related Experiment Video
Updated: Aug 5, 2026
Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Anterior cruciate ligament reconstruction with modified Lemaire lateral extra-articular tenodesis is associated with
Maximiliano Espinosa1, Daniel Pastrián2, Javier González3
1Departamento de Urgencia Escolar, Clínica Alemana Santiago, Facultad de Medicina Clínica Alemana Santiago - Universidad del Desarrollo, Santiago, Chile.
Introduction/Objective:
Anterior cruciate ligament (ACL) reconstruction in adolescents is associated with higher graft failure rates than in adults. Lateral extra-articular tenodesis (LET) may improve rotational stability and potentially reduce graft failure in this high-risk population. This study aimed to evaluate functional outcomes, return to sport (RTS), graft failure, and reintervention rates in adolescents undergoing ACL reconstruction combined with modified Lemaire LET.
Methods:
This prospective single-center cohort included patients younger than 18 years who underwent primary ACL reconstruction using a hamstring autograft combined with modified Lemaire LET and had a minimum follow-up of 12 months. Outcomes included the Lysholm score, International Knee Documentation Committee (IKDC) Subjective Knee Form, RTS rate and timing, graft failure, and reinterventions.
Results:
Fifty-five patients were included, with a median age of 16.8 years (interquartile range [IQR], 16.1-17.6); 36 patients were male (65.5%). The mean follow-up was 28.7 months (range, 12-36 months). At final follow-up, the median Lysholm score was 94.0 (IQR, 89.5-96.0), and the median subjective IKDC score was 85.0 (IQR, 80.0-89.0). RTS was achieved in 53 patients (96.4%) at a median of 12.0 months after surgery (IQR, 11.8-13.0). Graft failure occurred in five patients (9.1%) at a median of 17.0 months postoperatively (IQR, 15.0-17.0), and nine patients (16.4%) underwent ipsilateral knee reintervention during follow-up, including revision ACL reconstruction and additional meniscal or lateral extra-articular procedures.
Conclusion:
In this prospective cohort of adolescents undergoing ACL reconstruction combined with modified Lemaire lateral extra-articular tenodesis, short-term subjective knee function was favorable, return to organized sport occurred in 96.4% of patients, and graft failure occurred in 9.1%.
Level Of Evidence:
Level IV, therapeutic case series.