Why Adding an Extra Step to ACL Surgery Can Make a Difference

When you tear your ACL—that's the Achilles' heel of your knee—doctors often recommend a surgery called ACL reconstruction. One common type, called anatomic single-bundle ACL reconstruction (ACLR), aims to place the new ligament (called a graft) in just the right spot on your bone. This setup is thought to give good results, especially when the graft is positioned in a more diagonal way on the bone.But here’s the thing: even with this surgery, some people still struggle with what we call rotational instability—feeling like their knee is twisting too much. That’s why doctors started doing extra steps, like extra-articular augmentation and a procedure called lateral extra-articular tenodesis (LET). This extra step is meant to help reduce that unwanted twisting. Researchers recently looked at young adults who had these extra steps added to their ACL surgery. They were all dealing with rotational instability and general laxity in their joints. The study aimed to see how well the combination of arthroscopic single-bundle ACLR with additional LET worked out.