A surgical procedure called lateral extra-articular tenodesis (LET) boosts the recovery for patients suffering from anterior cruciate ligament (ACL) reconstruction.

LET is often performed at the same time as ACL repair, and it gives athletes added stability by reinforcing the outer side of the knee, which enhances stability.

How does LET work?

Doctors take a strip of tissue from the outer thigh and thread it through the knee in a way that limits unwanted twisting. This helps protect the new ACL as it heals.

“You take a strip that’s about eight centimeters long, pass it under the lateral ligament, then fix it back with a screw or staple,” said Mercy Medical Center orthopedic surgeon Dr. Mark Slabaugh.

Dr. Slabaugh said when he first started offering LET two years ago, only 10% of patients were getting it. Now, nearly half of his ACL surgeries include the added step.

While not for everyone, LET is showing strong results in young athletes who play sports that involve cutting, jumping, and fast changes in direction, including track, soccer, and basketball. 

Doctors say LET leads to fewer reinjuries and more athletes getting back to their sport at a high level.

“It’s not just about the surgery,” Dr. Slabaugh said. “It takes motivation and discipline. If someone’s not willing to do the work, we don’t recommend it.”

ACL surgery “is not a death sentence.”

Track and field athlete Norah O’Malley, who competes at Denison University in Ohio, tore her ACL nearly a year ago. The Baltimore County native didn’t know if that meant the end of her college athletic career.

She opted for the added LET procedure, and now she is back running.

“I didn’t expect to compete until a year after surgery,” O’Malley said. “But I ended up sprinting just eight months later.”

O’Malley was cleared to run again just five months after her surgery.

O’Malley was ready. Just five months after her surgery, she was cleared to run again. The typical timeline is six to 12 months for a full return to sports.

“I was expecting it to be really painful,” O’Malley said. “But I could get up and move around. The only difference now is the scar.”

For O’Malley, what started as a major setback became a powerful comeback.

Though it may sound intimidating, Dr. Slabaugh reminds athletes that an ACL tear does not have to be a career-ender.

“This is not a death sentence,” Dr. Slabaugh said. “They can get back to the sports they love, and a lot of times they don’t have that understanding.”

For now, O’Malley is focused on finishing strong and trusting her knee again.