Lateral Extra-Articular Tenodesis (LET)
At London Knee Care, Lateral Extra-Articular Tenodesis (LET) may be performed alongside ACL reconstruction to provide additional control of rotational knee movement. Mr Raghbir Khakha can assess your knee stability, injury history and activity goals to determine whether this procedure may be appropriate for you.
About Lateral Extra-Articular Tenodesis (LET)
At London Knee Care, lateral extra-articular tenodesis (LET) is a surgical procedure used to improve rotational stability in the knee. It involves using a strip of tissue from the iliotibial band along the outside of the thigh to help control excessive twisting of the knee, usually alongside anterior cruciate ligament (ACL) reconstruction.
LET may be recommended for selected patients at increased risk of ongoing knee instability or ACL graft reinjury, particularly those returning to sports involving sudden turns and changes of direction. Mr Raghbir Khakha can assess your knee stability, activity level and treatment goals to determine whether this additional procedure may be appropriate.
Additional Knee Stability
May Reduce Graft Reinjury Risk
Supports ACL Reconstruction
Specialist Surgical Assessment
When Is LET Surgery Recommended?
Lateral extra-articular tenodesis (LET) may be recommended alongside ACL reconstruction when a patient has significant rotational instability or factors that increase the risk of reinjury to the reconstructed ligament. The aim is to provide additional stability to the knee during movement, particularly when twisting or changing direction.
At London Knee Care, LET may be considered for patients undergoing revision ACL reconstruction, those with pronounced rotational instability, or individuals returning to high-demand pivoting sports such as football, rugby or skiing. Other factors, including joint hypermobility and previous ACL injuries, may also influence the treatment decision.
You may be a candidate for LET if your clinical assessment indicates that additional rotational stabilisation could benefit your ACL reconstruction. Your surgeon will assess your knee stability, injury history, activity level and sporting goals before recommending the most appropriate approach. LET is not necessary for every patient undergoing ACL surgery.
How to Book Your Appointment
Step 1
Schedule Your Consultation
Arrange an appointment with our knee specialist to discuss your ACL injury, knee instability, previous injuries and sporting goals.
Step 2
Detailed Knee Assessment
Our consultant will assess your knee stability, review your medical history and arrange imaging, such as an MRI, if required.
Step 3
Personalised Treatment Plan
Your consultant will explain your treatment options and determine whether LET alongside ACL reconstruction may be appropriate for your knee.
Step 4
Surgery and Recovery
If surgery is recommended, your treatment plan will include the procedure, postoperative care and structured rehabilitation to support recovery and a safe return to activity.
FAQs About LET Surgery
What factors determine whether LET should be added to ACL reconstruction?
At London Knee Care, Mr Raghbir Khakha assesses knee instability, joint laxity, previous injuries and sporting demands to determine whether LET may be beneficial. The recommendation is tailored to your individual risk factors and treatment goals.
Is LET necessary for every patient undergoing ACL reconstruction?
No, LET is not required for everyone undergoing ACL reconstruction. Mr Raghbir Khakha will assess your knee and discuss whether additional rotational stabilisation may be appropriate.
Can LET help if my previous ACL reconstruction has failed?
LET may be considered during revision ACL reconstruction when rotational instability or other risk factors increase the risk of further graft failure. At London Knee Care, Mr Raghbir Khakha will assess the reasons for the previous failure before discussing suitable treatment options.
How much can LET reduce the risk of ACL graft failure?
In a clinical trial involving high-risk patients aged 14–25 undergoing ACL reconstruction with a hamstring tendon graft, graft rupture over two years occurred in approximately 4% of patients receiving LET, compared with 11% receiving reconstruction alone. Mr Raghbir Khakha can explain how this evidence applies to your individual circumstances.
Should I consider LET if I play football, rugby or another pivoting sport?
LET may benefit selected athletes who participate in sports involving sudden turns, twisting and changes of direction. Mr Raghbir Khakha will consider your sporting goals, knee stability and injury risk before recommending an appropriate surgical approach.
Can LET be performed without ACL reconstruction?
LET is most commonly performed alongside ACL reconstruction to provide additional rotational stability rather than replace the ACL. Mr Raghbir Khakha will assess the cause of your knee instability and discuss suitable options for your specific injury.
A true professional with such a warm, charming, caring personality/manner. Cannot recommend this gentleman highly enough. Clearly at the top of his profession in every sense.
Verified Patient
Get Additional Knee Stability and Greater Confidence with LET Surgery
Specialist Knee Assessment
Personalised Surgical Planning
ACL Reconstruction Expertise