Original study: early patient-reported functional outcome of all-inside ACL reconstruction as compared to anteromedial portal technique.

Abstract

Anteromedial portal technique (AMP) using hamstring autograft is a popular technique of arthroscopic ACL reconstruction allowing anatomical placement of femoral. In this technique, a cortical suspensory fixation of graft is used on the femoral side and interference screw fixation on the tibial side using a complete bone tunnel. All-inside translateral technique is a recently introduced technique which uses a closed loop of quadrupled semitendinosus graft with an adjustable cortical suspensory fixation on both sides allowing optimum tensioning of graft and near-complete filling of retrosockets created by the flip cutter on both femoral and tibial sides. With its proposed but unproven benefits, our study was planned to compare the two techniques. A total of 80 young active males requiring ACL reconstruction surgery were equally randomized to AMP and All-inside technique. The primary objective of the study was to compare the ability to return to pre-injury level of activity using Tegner activity scale and patient-reported outcome using new Knee Society Score (KSS) at two years of follow-up. The mean improvement in Tegner score was significantly better (p = 0.0005) in all-inside group (2.34 ± 0.97) as compared to AMP group (1.5 ± 1.30). Among components of new KSS, patient satisfaction was better in all-inside group. All-inside ACL reconstruction provides a better chance of return to pre-injury level of activity with accompanied patient satisfaction as compared to AMP technique at two years of follow-up. Level I, therapeutic study.