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The secondary aim was to look at the clinical outcomes of the isolated LET to analyze whether biomechanical changes have an influence on clinical improvement or not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 52 patients who underwent an isolated modified Lemaire LET were prospectively studied. Twenty\u2010two were over 55\u2010year\u2010old patients with ACL rupture and subjective instability (group 1). They were followed up for 2 years postoperatively. Thirty were patients underwent a two\u2010stage ACL revision (group 2). They were followed up for 4\u00a0months postoperatively (up to the second stage of the ACL revision). Preoperative, intraoperative, and postoperative kinematic analyses were carried out using the KiRA accelerometer and KT1000 arthrometer to look for residual anterolateral rotational instability and residual anteroposterior instability. Functional outcomes were measured with the single\u2010leg vertical jump test (SLVJT) and the single\u2010leg hop test (SLHT). Clinical outcomes were evaluated using the IKDC 2000, Lysholm, and Tegner scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A significant reduction of both rotational and anteroposterior instability was detected. It was present both with the patient under anesthesia (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and <jats:italic>p<\/jats:italic>\u2009=\u20090.007 respectively) as well as with the patient awake (<jats:italic>p<\/jats:italic>\u2009=\u20090.008 and <jats:italic>p<\/jats:italic>\u2009=\u20090.018 respectively). Postoperative analysis of knee laxity did not show any significant variation from the first to the last follow\u2010up. Both the SLVJT and SLHT improved significantly at the last follow\u2010up (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and <jats:italic>p<\/jats:italic>\u2009=\u20090.011 respectively). The mean values of both the IKDC and Lysholm and Tegner scores showed an improvement (<jats:italic>p<\/jats:italic>\u2009=\u20090.008; <jats:italic>p<\/jats:italic>\u2009=\u20090.012; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The modified Lemaire LET improves the kinematics of ACL\u2010deficient knees. The improvement in the kinematics leads to an improvement in subjective stability as well as in the function of the knee and in the clinical outcomes. At the 2\u2010year follow\u2010up, these improvements were maintained in a cohort of patients over 55 years. Following our findings, to reduce knee instability, an isolated LET in ACL\u2010deficient knees may be used when ACL reconstruction in patients over 55 years is not indicated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-023-07344-9","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T22:03:21Z","timestamp":1677017001000},"page":"3212-3220","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Isolated lateral extra\u2010articular tenodesis in ACL\u2010deficient knees: in vivo knee kinematics and clinical outcomes"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0010-024X","authenticated-orcid":false,"given":"Simone","family":"Perelli","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Surgery and Morphologic Science, Orthopaedic Surgery Service Universitat Aut\u00f2noma de Barcelona, Hospital del Mar Barcelona Spain"},{"name":"<!--<label>2<\/label>--> Knee and Arthroscopy Unit, Department of Orthopedic Surgery Institut Catal\u00e1 de Traumatologia I Medicina de L\u2019Esport (I.C.A.T.M.E.), Hospital Universitari Dexeus, Universitat Autonoma de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Eduardo","family":"Gelber","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Knee and Arthroscopy Unit, Department of Orthopedic Surgery Institut Catal\u00e1 de Traumatologia I Medicina de L\u2019Esport (I.C.A.T.M.E.), Hospital Universitari Dexeus, Universitat Autonoma de Barcelona Barcelona Spain"},{"name":"<!--<label>3<\/label>--> Department of Orthopaedic Surgery Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Morales\u2010Avalos","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Department of Physiology, School of Medicine Universidad Autonoma de Nuevo Le\u00f3n (U.A.N.L.) Monterrey Nuevo Le\u00f3n M\u00e9xico"},{"name":"<!--<label>5<\/label>--> Department of Orthopedic Surgery and Traumatology Knee UnitSchool of Medicine and University Hospital \u201cDrJos\u00e9 Eleuterio Gonz\u00e1lez\u201d, Universidad Autonoma de Nuevo Le\u00f3n (U.A.N.L.) Monterrey Nuevo Le\u00f3n M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Ronco","sequence":"additional","affiliation":[{"name":"<!--<label>6<\/label>--> Orthopaedic Surgery Department, E. Agnelli Hospital Pinerolo (Turin) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Torres\u2010Claramunt","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Surgery and Morphologic Science, Orthopaedic Surgery Service Universitat Aut\u00f2noma de Barcelona, Hospital del Mar Barcelona Spain"},{"name":"<!--<label>2<\/label>--> Knee and Arthroscopy Unit, Department of Orthopedic Surgery Institut Catal\u00e1 de Traumatologia I Medicina de L\u2019Esport (I.C.A.T.M.E.), Hospital Universitari Dexeus, Universitat Autonoma de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Espregueira\u2010Mendes","sequence":"additional","affiliation":[{"name":"<!--<label>7<\/label>--> Cl\u00ednica Espregueira FIFA Medical Centre of Excellence Porto Portugal"},{"name":"<!--<label>8<\/label>--> School of Medicine University of Minho Braga Portugal"},{"name":"<!--<label>9<\/label>--> Dom Henrique Research Centre Porto Portugal"},{"name":"<!--<label>10<\/label>--> ICVS\/3B\u2019s\u2013PT Government Associate Laboratory Braga\/Guimar\u00e3es Portugal"},{"name":"<!--<label>11<\/label>--> 3B\u2019s Research Group\u2014Biomaterials, Biodegradables and Biomimetics University of Minho, European Institute of Excellence On Tissue Engineering and Regenerative Medicine Guimar\u00e3es Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan Carles","family":"Monllau","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Surgery and Morphologic Science, Orthopaedic Surgery Service Universitat Aut\u00f2noma de Barcelona, Hospital del Mar Barcelona Spain"},{"name":"<!--<label>2<\/label>--> Knee and Arthroscopy Unit, Department of Orthopedic Surgery Institut Catal\u00e1 de Traumatologia I Medicina de L\u2019Esport (I.C.A.T.M.E.), Hospital Universitari Dexeus, Universitat Autonoma de 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