Modified All Inside Acl Reconstruction

Modified All Inside Acl Reconstruction

Suresh Perumal, MS(Orth), INDIA Arumugam Sivaraman, MS(Orth), AB(IM)(USA), FRCS(Glasg), INDIA Parthiban Jeganathan, MS, INDIA Prakash Ayyadurai, MS, INDIA

Sri Ramachandra Institute of higher education and research, Chennai, Tamilnadu, INDIA


2025 Congress   ePoster Presentation   2025 Congress   Not yet rated

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Ligaments

ACL

Patient Populations

Diagnosis Method

MRI

Sports Medicine


Summary: All inside ACL-R requires specialised instruments such as retrograde drills to create closed bony sockets, which is not readily available in all centres. To overcome this we have modified our technique of all inside ACLR by retaining all major advantages of conventional All inside ACL.


Background

All-inside anterior cruciate ligament reconstruction (ACLR) technique is also one of the many technique involved in ACLR which involves the use of quadrupled semitendinosus (ST) graft and suspension devices at both tibial and femoral sites.The all-inside ACLR technique was developed to improve patient outcomes by reducing the procedure’s invasiveness, minimizing complications by closed-socket tunnels, reduced bone removal, smaller skin incisions, enhanced cosmesis, less postoperative pain and preservation of the gracilis.

Questions/Purposes
Although this technique can be applied to all patients with ACL-R, it requires specialised instruments such as retrograde drills to create closed bony sockets, which is not readily available in all centres. To overcome this existing problem, we have modified our technique of all inside ACLR by retaining all major advantages of conventional All inside ACL.

Methods

26 patients with modified all inside ACLR were compared with 40 patients undergoing conventional transportal ACLR with no other concomitant ligament injuries were studied.
All patients had mean followup of 1 year and were analysed for VAS and Lysholm functional score at 1 month, 3 months and 6 months followup, range of movements, graft rerupture complications.

Results

Functional recovery of modified all inside ACLR was better than conventional ACLR in 1 month, however both the results were similar at the end of 6 months time. Both the technique are equally efficacious in terms of final outcome.

Conclusion

We overcame the shortcoming in conventional All inside ACL such as specialised tibial reamers and need for intra-articular graft length management by making our modified All inside ACL reconstruction technique, a time efficient and less demanding procedure.

Keywords: modified All inside ACL, anterior cruciate ligament reconstruction technique, tibial tunnel, semi-tendinosus