Two-hundred and twenty-six patients with chronic anterior laxity of the knee treated by Lemaire extra-articular ligamentoplasty were assessed after a follow-up of 2 to 9 years, with a mean of 4.5 years. Fifty-five knees had only an anterior laxity and 166 anterior laxity combined with medial laxity, in 100 of which tensioning or reinforcement of the medial ligament was needed. Forty-two per cent of sporting patients were able to return to sport at the same level, though half of them had some discomfort. Fifty-one per cent of patients did not experience any instability in daily and working life but half of them had occasional pain. Sixty-one per cent of knees did not, at review, show a positive MacIntosh pivot shift test and the absence of pivot shift correlated statistically with the quality of the functional result. In seventy-three per cent of knees there was a positive Lachmantest indicating definite laxity at the review. Thirty per cent of knees developed a lateral laxity, which questions the innocuousness of removal of the iliotibial tract. Twenty-seven per cent showed radiological deterioration of the medial joint space. A comparison of these results with the published results of intra-articular ligamentoplasty suggests that extra-articular ligamentoplasty with fascia lata should be limited to the treatment of isolated chronic anterior ligament laxity in middle-aged patients who do not participate in strenuous sporting activities.