Should you ask your surgeon about adding an LET?

An LET (lateral extra-articular tenodesis) is an extra stabilizing stitch sometimes added to ACL (anterior cruciate ligament) reconstruction. It is not right for everyone — but for some patients it can cut the chance of the new ligament tearing again. This site helps you learn whether it is worth a conversation with your surgeon.

Anatomical illustration of a knee joint shown from the front. The thigh bone (femur) sits above and the shin bone (tibia) below, separated by the joint space. In the center of the joint, the torn ACL is visible as a frayed reddish stump of tissue. The two C-shaped menisci sit on either side of the joint, on top of the shin bone.

What's here

ACL basics

What the ACL does, how it tears, and what happens during reconstruction surgery — in plain language.

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Graft types

Not all replacement ligaments are the same. Learn the difference between hamstring, patellar tendon, quad tendon, and donor grafts.

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What is an LET?

The lateral extra-articular tenodesis (LET) is an extra stabilizing procedure. Find out what it is, when it helps, and what the research says.

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How the tool works

The interactive tool asks you 11 questions in plain patient language — one at a time, on any device. Every question includes an "I don't know" option, so you never have to guess. Each answer adds or does not add points based on the strength of published research linking that factor to whether an LET is likely to help. When you finish, the tool places your answers into one of three result categories and shows you exactly which answers pushed the result in each direction. No matter which category you land in, the result always ends by telling you to discuss the findings with your surgeon — because only your surgeon can weigh your full picture. Nothing you enter is sent anywhere or saved; everything runs inside your browser and disappears when you close the page.

Who built this

This site was written by an orthopedic sports medicine surgeon as educational material for patients preparing to discuss ACL reconstruction. It is not affiliated with any hospital, device company, or product. All algorithm factors trace to peer-reviewed, published research. The tool is meant to inform conversations — not replace them.