الفهرس 
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Abstract
The primary function of the ACL is to prevent anterior translation of the tibia& also as a secondary stabilizer against the internal rotation of the tibia and valgus angulation of the knee(12).
Rupture of the anterior cruciate ligament (ACL) is a serious and common injury in elite, recreational sport players and high demand patients as manual workers (65). Unsuccessful results from ACLR have ranged from 3% to 52% in the literature depending on the criteria used to define failure (4). Furthermore, studies have shown that up to 40% of patients never make it back to their preinjury activity level with respect to sports intensity, frequency, and performance. Also, Persistent anterolateral rotatory instability after ACLR has been correlated with poor clinical outcomes and graft failure (5).
More recently, a significant focus has been placed upon the anterolateral complex (ALC) of the knee, a combination of structures on the lateral side of the knee that aid in the control of anterolateral rotatory laxity. The ALC includes the superficial and deep iliotibial band (ITB), the capsulo-osseous layer of the ITB and a thickening of the lateral capsule referred to as the anterolateral ligament (ALL) (2).
An attempt to decrease the failure rate caused by persistent anterolateral rotatory laxity, modifications of surgical techniques developed as combining lateral extra-articular tenodesis with ACLR. The goal of LET is placing a lateral soft tissue restraint a distance from the central pivot of the knee, thereby improving the mechanical advantage to control rotation when treating the ACL-deficient knee (46).
The aim of this study is to compare the clinical outcome and failure rate of arthroscopic anatomical single bundle ACL reconstruction with and without lateral extra-articular tenodesis in a comparable patient population of high demand patient with isolated ACL tear through conducting a randomized control trial with midterm follow up period of one year.
Our study included 41 patients and enrolled in Ain Shams university hospital, held from December 2020 till December 2022. Patients included in this study randomized into 2 groups. group A included 20 patients treated with ACLR combined with LET by modified Lemaire technique. group B included 21 patients treated with ACLR alone. Two patients from group B were lost during follow up. So, in total 20 patients in group A and 19 patients in group B were available for follow for 12 months.
Our study showed statistically nonsignificant higher failure rate among patients treated with anatomical single bundle ACLR in comparison to patients treated with ACLR combined with LET. Our study also showed that there is significantly greater improvement in subjective patient outcome scores (IKDC &Lysholm) and objective side to side difference assessments by KT1000 Lachmeter® at 12 months follow up.
The results of this study showed that more improvement in patients subjective outcome score (IKDC &Lysholm) all through the follow up period at 3,6,9 and 12 months in favor to patients included in group A than group B. And this difference is statistically significant difference at 9 & 12 months for IKDC and at 6 & 12 months for Lysholm.