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Kinematic tests were performed in the following states: intact; anterolateral knee lesion (AL\u2010Les); modified Lemaire lateral extra\u2010articular tenodesis (LET) with the femoral iliotibial band (ITB) strip fixed on the cortical surface (cortical fixation), deep to the lateral collateral ligament (LCL) (deep LET\u2010C); and LET with the femoral ITB strip fixed into a tunnel (intra\u2010tunnel fixation), deep to the LCL (deep LET\u2010IT) or superficial to the LCL (superficial LET\u2010IT). The knee kinematic changes in the AL\u2010Les state and the 3 LET states were compared with each other, with the intact state as the baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the AL\u2010Les state, the increased anterior translation instabilities were significantly mitigated by the 3 LETs at 30\u00b0, 60\u00b0, and 90\u00b0 (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), with overconstraint observed in both the deep LET\u2010IT and superficial LET\u2010IT states at 60\u00b0 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .047 and\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001, respectively) and 90\u00b0 (both\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Similarly, the 3 LETs significantly reduced the internal rotation instabilities in the AL\u2010Les state at all flexion angles. The superficial LET\u2010IT state overconstrained the knee at 60\u00b0 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .009) and 90\u00b0 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) during internal rotation torque, and the deep LET\u2010IT state did so at 60\u00b0 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .012). Furthermore, the ALT instabilities found in the AL\u2010Les state were significantly reduced by the 3 LETs during the simulated pivot\u2010shift test. At 30\u00b0 and 45\u00b0, these LET states resulted in overconstraint when compared with the intact state, but the superficial LET\u2010IT state (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) or deep LET\u2010IT state (\n                      <jats:italic>P<\/jats:italic>\n                      = .016) presented a larger overconstraint than that in the deep LET\u2010C at 45\u00b0, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The 3 Lemaire LET procedures evaluated reduced the anterior, internal rotational, and ALT laxities in AL\u2010Les knees and restored these parameters to the native baseline of the intact state at most flexion angles. However, in deep flexion, some overconstraint occurred in all LETs when compared with the intact state, of which the deep LET\u2010C state resulted in less overconstraint in anterior translation and internal rotation than the deep LET\u2010IT and superficial LET\u2010IT states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>This biomechanical study supports using the femoral cortical fixation technique to fix the ITB strip in the modified Lemaire LET, which similarly improves knee kinematic stability and causes less overconstraint compared with conventional intra\u2010tunnel fixation. These findings need more verification in clinical scenarios.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2022.06.016","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T20:57:26Z","timestamp":1656449846000},"page":"3162-3171","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":24,"title":["Modified Lemaire Lateral Extra\u2010articular Tenodesis With the Iliotibial Band Strip Fixed on the Femoral Cortical Surface Reduces Laxity and Causes Less Overconstraint in the Anterolateral Lesioned Knee: A\u00a0Biomechanical Study"],"prefix":"10.1002","volume":"38","author":[{"given":"Junjie","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Sports Medicine Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caiqi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikui","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinzhong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211002282"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.04.028"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06416-4"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.03.008"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.811.BJR-2019-0103.R1"},{"key":"e_1_2_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.04.089"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.10.017"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4596-5"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517724422"},{"key":"e_1_2_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.03.027"},{"key":"e_1_2_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2016.08.009"},{"key":"e_1_2_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.02.041"},{"key":"e_1_2_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.11.011"},{"key":"e_1_2_3_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519854220"},{"key":"e_1_2_3_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516681555"},{"key":"e_1_2_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2020.09.006"},{"key":"e_1_2_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2019.09.010"},{"key":"e_1_2_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4537-3"},{"key":"e_1_2_3_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520959322"},{"key":"e_1_2_3_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519856331"},{"key":"e_1_2_3_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515589166"},{"key":"e_1_2_3_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519876107"},{"key":"e_1_2_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.01.026"},{"key":"e_1_2_3_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515620183"},{"key":"e_1_2_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.10.038"},{"key":"e_1_2_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.06.023"},{"key":"e_1_2_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.10.030"},{"key":"e_1_2_3_29_2","doi-asserted-by":"crossref","unstructured":"Xu J Ye Z Han K Xu C Zhao J Dong S. 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