Lemaire Procedure

What Is the Lemaire Procedure?

The Lemaire Procedure, also called Lateral Extra-Articular Tenodesis (LET), is a surgical technique that may be performed alongside an ACL reconstruction to provide additional rotational stability to the knee.

During the procedure, the surgeon uses a portion of the patient’s iliotibial (IT) band and attaches it between the femur and tibia to help reinforce the reconstructed ACL. This additional support helps limit excessive rotation within the knee and may reduce the likelihood of reinjury.

Rather than replacing the ACL reconstruction, the Lemaire Procedure serves as an added layer of protection for appropriately selected patients.

Who Should Have the Lemaire Procedure?

Fox Valley Orthopedics may recommend the Lemaire Procedure for patients undergoing ACL reconstruction who are considered at higher risk for reinjury or rotational instability of the knee.

The procedure is often considered for:

• Young athletes
• Competitive athletes
• Patients returning to cutting or pivoting sports
• Individuals with significant rotational knee instability
• Patients at increased risk for ACL retear

Because the procedure is performed in conjunction with ACL reconstruction, your orthopedic sports medicine specialist will evaluate whether adding a Lemaire LET is appropriate based on your injury pattern, activity level, and long-term goals.

How Well Does the Lemaire Procedure Work?

The Lemaire Procedure has gained attention because of its ability to significantly reduce the risk of ACL reinjury. At Fox Valley Orthopedics, the procedure is viewed as an important advancement in ACL treatment, particularly for young athletes.

A study involving elite Alpine ski athletes found that adding LET to ACL reconstruction resulted in a five-fold reduction in reinjury rates.

Additional benefits include:

• Improved rotational knee stability
• Reinforcement of the reconstructed ACL
• Reduced risk of retear
• No significant change to rehabilitation protocols
• Minimal additional surgical time

The procedure typically adds only about 15 minutes to the overall ACL surgery.

What Can I Expect When I Have the Lemaire Procedure?

The Lemaire Procedure is performed at the same time as ACL reconstruction surgery. You will undergo the same preoperative evaluation, anesthesia process, and recovery pathway that is typical for ACL reconstruction patients.

During the procedure:

• The ACL reconstruction is performed.
• A portion of the iliotibial (IT) band is harvested.
• The graft is used to reinforce the outside of the knee.
• The LET construct is secured between the tibia and femur.
• Knee stability is assessed before surgery is completed.

One of the advantages of the procedure is that it does not significantly alter the rehabilitation timeline for ACL recovery. Patients generally follow the same postoperative rehabilitation plan as they would for a standard ACL reconstruction.

Recovery typically includes:

• Physical therapy
• Range-of-motion exercises
• Progressive strengthening
• Balance and stability training
• Sport-specific rehabilitation
• Gradual return to activity

For athletes, returning to competitive sports typically requires 8 to 12 months of rehabilitation and functional recovery after ACL reconstruction.

Typical Time Away From Work

Office/Sedentary Roles: Typically 1 to 3 weeks

Moderately Active Roles: Typically 4 to 8 weeks

Strenuous/Physical Roles: Typically 3 to 6 months

Competitive Athletics: Often 8 to 12 months before full return to sport, depending on recovery progress and physician clearance.

Why Choose Fox Valley Orthopedics for the Lemaire Procedure?

Fox Valley Orthopedics’ sports medicine specialists routinely perform the Lemaire LET procedure as an adjunct to ACL reconstruction. The technique helps provide additional knee stability while reducing the risk of future ACL injury, particularly in young and highly active athletes.

By combining advanced surgical techniques with comprehensive rehabilitation programs, our goal is to help patients return to sports and everyday activities with confidence while minimizing the risk of reinjury.