Comparison of the ability of two different techniques used to augment anterior cruciate cruciate ligament reconstruction, to improve the stability of the knee and reduce the risk of re-tearing the reconstructed ligament, in patients taking part in pivoting sports.

INTERVENTION: The LET procedure involves taking a 1cm strip of the ITB, 15cm long, left attached distally, and then re‐routed deep to the proximal lateral collateral ligament (LCL) of the knee and attached to the periosteum posterior and superior to the LCL where it is secured under hand tension using a titanium bone staple. The surgery is performed by a consultant orthopaedic surgeon and takes approximately 30 mins to perform. The surgeon is one of the researchers so adherence to the intervention is not indicated and the operative notes document the procedure performed. The study is on‐going and may last for 20 years. CONDITION: Anterior cruciate ligament rupture; ; Anterior cruciate ligament rupture Surgery ‐ Surgical techniques PRIMARY OUTCOME: Meniscal tear diagnosed at second look arthroscopy[2 years] Recurrent ACL rupture diagnosed with recurrence of the pivot shift on clinical assessment and MRI. [2 years] SECONDARY OUTCOME: ACL Quality of Life Questionnaire (QOL) [2 years] Knee function measured with International Knee Documentation Committee (IKDC) [2 years] Knee injury Osteoarthritis and Outcome Score (KOOS)[2 years] Tegner activity scores (TAS)[2 years] INCLUSION CRITERIA: ACL rupture confirmed on MRI and at time of surgery, the presence of clinical signs of instability immediate following the performance of the ACL reconstruction when the patients re‐assessed after the ACL reconstruction (the presence of a pivot shift test despite the ACL reconstruction) involved in sports that require twisting / pivoting, desirous to return to this sport, patient willing to be randomly allocated to either treatment group, Tegner activity score of at least 7