Table 1.

Advantages and Disadvantages of Lateral Extra-Articular Tenodesis With Iliotibial Band Using Knotless All-Suture Anchor Femoral Fixation

Advantages	Disadvantages
LET augments knee stability and can reduce the pivot shift when performed with ACLR in the ACL injured knee.	The procedure requires additional operative time and soft tissue dissection when compared to ACLR alone.
No allograft is necessary, as autograft IT band is used.	There is associated donor site morbidity with IT band autograft harvest.
LET may be performed at the time of ACLR and does not need to be staged.	There is a possibility to iatrogenic injury to ACLR femoral fixation when dissecting about the lateral epicondyle.
Use of a knotless anchor for femoral fixation is low profile and results in minimal surrounding soft tissue irritation	The graft may be excessively tensioned if the knee is externally rotated during tensioning.
LET with IT band may be useful in revision ACLR, where concern for residual rotational instability after index procedure is a concern for primary ACLR failure.	The IT band may have scarring from primary ACLR graft passage or fixation in the revision setting, making it difficult to mobilize.

ACLR, anterior cruciate ligament reconstruction; IT, iliotibial; LET, lateral extraarticular tenodesis.