Simplifying Iliotibial Band Lateral Extra-articular Tenodesis Fixation During Anterior Cruciate Ligament Reconstruction: A Hardware-Sparing Approach.

The addition of a lateral extra-articular tenodesis to anterior cruciate ligament reconstruction has been shown to reduce graft failure and improve rotational stability, but current fixation methods often require additional tunnels or hardware, with risks of tunnel convergence, irritation, and hardware removal. This technical paper describes a modified Lemaire lateral extra-articular tenodesis technique in which the iliotibial band flap is secured directly to the femoral suture button of the anterior cruciate ligament graft, thereby avoiding additional fixation devices. This technique minimizes the risk of tunnel convergence, leaves a smoother lateral condylar surface, and reduces postoperative irritation associated with metallic fixation, while providing strong fixation in the isometric zone.