All-Inside Anterior Cruciate Ligament Reconstruction —A Systematic Review of Techniques, Outcomes, and Complications

J Knee Surg DOI: 10.1055/s-0038-1627446The all-inside technique (AIT) for anterior cruciate ligament reconstruction (ACLR) is gaining popularity as a more anatomic, less invasive, technique with the potential for more rapid recovery. This systematic review aims to critically assess components of the technique, its safety profile, outcomes, and complications. PUBMED, EMBASE, and MEDLINE were searched for studies discussing primary ACLR using the AIT. Article screening, quality assessment, and data abstraction were completed in duplicate, and a minimal clinically important difference (MCID) was used to frame the descriptive results in a clinically significant context. A total of 13 studies satisfied the inclusion criteria. Five-hundred twenty six patients (mean age 31.9 ± 5.9 years) underwent ACLR using the AIT. The mean follow-up was 18.2 ± 7.7 months. Graft choice included autograft (73.8%) and allograft (26.2%). Drilling techniques for femoral sockets were outside-in (53.4%) and through the anteromedial portal (35.4%), whereas tibial sockets were drilled outside-in (35.0%) and through the superomedial portal (3.8%). The rehabilitation protocol had an immediate focus on obtaining full knee extension, jogging permitted 2 to 4 months postoperatively in 61.5% of studies, and return to cutting and pivoting sports 6 to 9 months postoperatively in 69.2% of studies. A MCID was reached for subjective International Knee Documentation Committee...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

Related Links:

AbstractPurposeAim of this study is to document if combined meniscal allograft transplantation (MAT) and ACL reconstruction can improve knee function, reduce pain and allow patients with meniscal defect and ACL lesion to resume sport activities.MethodsFifty MAT, arthroscopically performed without bone plugs and combined with one-stage primary or revision ACL reconstruction, with or without high tibial osteotomy (HTO), were included. Patients (aged 38.2  ± 10.6 years, 87% males) were evaluated at a mean follow-up of 5 years with Lysholm, Tegner and VAS scores. Patient satisfaction was also recorded...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
ConclusionsThe findings of this study showed that anterior knee laxity is restored with revision BPTB autograft ACLR after failed primary HT autograft ACLR, in the same cohort of patients. However, revision ACLR showed a significantly inferior functional knee outcome compared with primary ACLR. It is important for clinicians to inform and set realistic expectations for patients undergoing revision ACLR. Patients must be aware of the fact that having revision ACLR their knee function will not improve as much as with primary ACLR and the final postoperative functional outcome is inferior.Level of evidenceRetrospective cohort study, Level III.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Publication date: Available online 11 June 2018Source: Arthroscopy TechniquesAuthor(s): Avinesh Agarwalla, Richard Puzzitiello, Grant H. Garcia, Brian ForsytheAbstractAnterior cruciate ligament (ACL) reconstruction with a bone–patellar tendon–bone autograft yields good clinical outcomes. Despite appropriate clinical outcomes, the most common complaint after reconstruction with a bone–patellar tendon–bone autograft is anterior knee pain at the donor graft sites. Synthetic bone grafts, such as beta-tricalcium phosphate (β-TCP), have been previously used to fill the bony defect in fractures as wel...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
ConclusionIt is ascertained that no significant retro-patellar pain or shortening of the patellar tendon occurs following a bone patella tendon bone harvest. The bone patella bone tendon graft is a suitable graft for ligament reconstruction with good functional outcome, and no significant adverse effect of patella baja or anterior knee pain in the Indian patients.Level of EvidenceLevel IV.
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
Publication date: Available online 11 June 2018Source: Arthroscopy TechniquesAuthor(s): Avinesh Agarwalla, Richard Puzzitiello, Grant H. Garcia, Brian ForsytheAbstractAnterior cruciate ligament (ACL) reconstruction with a bone–patellar tendon–bone autograft yields good clinical outcomes. Despite appropriate clinical outcomes, the most common complaint after reconstruction with a bone–patellar tendon–bone autograft is anterior knee pain at the donor graft sites. Synthetic bone grafts, such as beta-tricalcium phosphate (β-TCP), have been previously used to fill the bony defect in fractures as wel...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
ConclusionIt is ascertained that no significant retro-patellar pain or shortening of the patellar tendon occurs following a bone patella tendon bone harvest. The bone patella bone tendon graft is a suitable graft for ligament reconstruction with good functional outcome, and no significant adverse effect of patella baja or anterior knee pain in the Indian patients.Level of EvidenceLevel IV.
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
AbstractPurposeTo compare anterior knee laxity and patient-reported outcome measures (PROMs) between anterior cruciate ligament reconstruction (ACLR) performed with bone –patellar tendon–bone (BPTB) and hamstring tendon (HT) autografts and, moreover, to study any correlation between postoperative anterior knee laxity and PROMs.MethodsPatients who underwent primary ACLR at Capio Artro Clinic, Stockholm, Sweden, from January 2000 to October 2015, were identified in our local database. Instrumented laxity measurements and PROMs were reviewed. The KT-1000 arthrometer, with an anterior tibial load of 134-N, was used...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Publication date: Available online 11 June 2018 Source:Arthroscopy Techniques Author(s): Avinesh Agarwalla, Richard Puzzitiello, Grant H. Garcia, Brian Forsythe Anterior cruciate ligament (ACL) reconstruction with a bone–patellar tendon–bone autograft yields good clinical outcomes. Despite appropriate clinical outcomes, the most common complaint after reconstruction with a bone–patellar tendon–bone autograft is anterior knee pain at the donor graft sites. Synthetic bone grafts, such as beta-tricalcium phosphate (β-TCP), have been previously used to fill the bony defect in fractures as well as ...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
J Knee Surg DOI: 10.1055/s-0038-1655764Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade ...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
Objective: We aimed to quantitatively assess the outcomes of studies, comparing the use of Bone-patellar tendon-bone (BPTB) and the quadriceps tendon-bone (QTB) autografts when reconstructing the anterior cruciate ligament (ACL). Data Sources: MEDLINE, Embase, and CINAHL databases were searched for relevant articles published between January 1980 and January 2015 for the purpose of identifying studies comparing BPTB and QTB autografts for ACL reconstruction. Included studies were assessed regarding their methodological quality before analysis. Outcomes analyzed were graft failure rates, objective and subjective stabil...
Source: Clinical Journal of Sport Medicine - Category: Sports Medicine Tags: Critical Review Source Type: research
More News: ACL Reconstruction | Bone Graft | Men | Pain | Rehabilitation | Sports Medicine | Study