Does the Lemaire IT Band Affect ACL Recon Outcomes?

Adding the modified Lemaire IT band tenodesis technique to anterior cruciate ligament (ACL) reconstruction may improve outcomes for athletes under the age of 20, a new Hospital for Special Surgery (HSS) study finds.

Frank Cordasco, M.D., M.S., sports medicine surgeon at HSS, and Daniel W. Green, M.D., M.S., FAAP, FACS, a HSS pediatric orthopedic surgeon saw promising results with the modified technique in 28 patients.

The study, “Anterior Cruciate Ligament Reconstruction with Iliotibial Band Tenodesis in Patients Under the Age of 20” was presented as part of the American Academy of Orthopaedic Surgeons 2020 Virtual Education Experience.

“An ACL re-injury in the young adolescent athlete, who has undergone an ACL reconstruction and nine to 12 months of rehabilitation, is a devastating clinical problem that sports medicine orthopedic surgeons continue to confront in the United States and around the world,” Cordasco said. “Our goal is to reduce the risk of re-injury as these athletes return to sports and prevent additional surgery involving the same knee or the uninjured knee to the extent that is possible.”

The technique involves using an 8-cm-by-1-cm strip of the iliotibial (IT) band, the long strap of connective tissue that extends from the hip to the knee on the outer side of the leg which requires an additional 5-cm incision. The surgeon uses the strip to create a tether around the lateral collateral ligament to limit instability.

Modified Lemaire IT band tenodesis, which is named after French surgeon Marcel Lemaire, is performed at the end of an ACL reconstruction. It has already been used in Europe with success.

“The biggest study so far has been from Europe, where studies have demonstrated the modified Lemaire IT band tenodesis has been proven successful in professional or semi-professional soccer players,” Green added. “At HSS, we’re proud to be one of the first groups to use this technique in high-risk teenage athletes in North America.”