Anterior Cruciate Ligament Reconstruction with Modified MacIntosh LET

Modified MacIntosh lateral extra-articular tenodesis. The MacIntosh LET [1] and its modified derivatives (e.g. Arnold-Coker technique [2]) are similar, and require harvesting a 1cm central or posterior portion of the ITB, again left attached at Gerdy’s tubercle and routed deep to the LCL. However, rather than anchoring the graft proximally, it is sutured back on itself and to the periosteum of Gerdy’s tubercle, creating a “sling”.

1. MacIntosh D, Darby T. Lateral substitution reconstruction. In Proceedings of the Canadian Orthopaedic Association. J Bone Joint Surg Am. 1976;58:142.
2. Arnold JA. A lateral extra-articular tenodesis for anterior cruciate ligament deficiency of the knee. Orthop Clin North Am. 1985;16:213-222.