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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

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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
J Knee Surg DOI: 10.1055/s-0038-1641175The purpose of this study was to describe our surgical technique of using five-strand hamstring autograft with interference screw fixation in primary anterior cruciate ligament (ACL) reconstruction and to report the early postoperative outcomes of this technique. Patients who underwent primary ACL reconstruction using five-strand hamstring autografts with interference screw fixation between December 2014 and June 2016 were included in this study. The five-strand configuration was used in these patients because the four-strand configuration produced a graft diameter of less than 8 mm. ...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
Short-Term Effects of the Kinesio Taping® on Early Postoperative Hip Muscle Weakness in Male Patients With Hamstring Autograft or Allograft Anterior Cruciate Ligament Reconstruction. J Sport Rehabil. 2017 Dec 18;:1-21 Authors: Balki S, GöktaƟ HE Abstract OBJECTIVE: Kinesio Taping® (KT) is a widely used treatment method in musculoskeletal rehabilitation. Little is known about the KT treatment and hip strength in patients with anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to investigate the effectiveness of the KT treatment on hip muscle weakness in early r...
Source: Journal of Sport Rehabilitation - Category: Sports Medicine Tags: J Sport Rehabil Source Type: research
Discussion There are substantial numbers of short-, medium- and long-term complications related to the harvesting of the two main ACL autografts. Effective means of prevention exist to reduce the risk of these complications. Level of evidence: II Systematic review of literature
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Publication date: Available online 14 August 2017 Source:Arthroscopy Techniques Author(s): Rachel M. Frank, Jason T. Hamamoto, Eamon Bernardoni, Gregory Cvetanovich, Bernard R. Bach, Nikhil N. Verma, Charles A. Bush-Joseph Hamstring tendon autograft remains a popular graft choice for anterior cruciate ligament (ACL) reconstruction. Although there are a variety of autograft and allograft options available for ACL reconstruction, advantages of hamstring tendon autografts include decreased postoperative knee pain and an overall easier surgical recovery compared with bone patellar tendon bone autograft. In addition, 4-strande...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
We describe a technique for ACL reconstruction with autogenous hamstring-bone graft, aiming to produce a type of graft that combines the main advantages of BPTB and hamstring grafts, with avoidance of the main disadvantages of these 2 most commonly used graft types in ACL reconstruction.
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Abstract This case report describes a 42-year-old woman who was diagnosed with pigmented villonodular synovitis (PVNS) in the knee. The patient had received a bone-patella tendon-bone autograft reconstruction of her anterior cruciate ligament (ACL) 22 years prior to her diagnosis of PVNS. After a traumatic event that tore her ACL graft, she underwent a second surgery to repair the initial reconstruction. However, her pain and joint instability remained unresolved. When radiolucent lesions in her tibia and femur were identified through a radiographic image, the patient was referred to the authors' orthopedic oncolo...
Source: Orthopedics - Category: Orthopaedics Authors: Tags: Orthopedics Source Type: research
Publication date: Available online 31 July 2017 Source:Arthroscopy Techniques Author(s): Rachel M. Frank, John Higgins, Eamon Bernardoni, Gregory Cvetanovich, Charles A. Bush-Joseph, Nikhil N. Verma, Bernard R. Bach Anterior cruciate ligament reconstruction with bone–patellar tendon–bone autograft has long been considered the graft preference for young, active patients with anterior cruciate ligament injuries. The central-third of the native patellar tendon is a reliable graft and is the preferred option for competitive athletes given its excellent track record with high return-to-play rates and low failure ra...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Authors: Lenz K, Jensen K, Tanggaard K, Vazin M, Bendtsen TF, Chan V, Krogsgaard MR, Strube ML, Børglum J Abstract BACKGROUND: Anterior cruciate ligament reconstruction (ACL-RC) is often associated with moderate to severe postoperative pain even with a multimodal analgesic regimen. We aimed to compare the analgesic efficacy of low volume saphenous-obturator block with placebo and femoral- obturator block in patients undergoing ACL-RC. METHODS: In a randomized controlled trial eighty-two patients undergoing ACL-RC with hamstring autograft were allocated to either low volume saphenous-obturator block, plac...
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
ConclusionThere is no significant difference between PRO 2  years post-operative using either QT or HT autografts. Both QT and HT grafts show acceptable and comparable PRO scores making the QT a reliable graft alternative to HT for primary ACL reconstruction.Level of evidenceIII.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
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