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

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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 of evidence

Level I, therapeutic study.

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Funding

No financial support received from any agency.

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Authors and Affiliations

  1. Senior Advisor & Head of Department, Department of Orthopaedics, Command Hospital (WC), Chandimandir, 134107, India

    Vikas Kulshrestha

  2. Classified Specialist Orthopaedics and Trained in Arthroscopy, Command Hospital (WC), Chandimandir, 134107, India

    Munish Sood

  3. Classified Specialist Orthopaedics, Department of Orthopaedics, Command Hospital Air Force Station Bangalore, Bengaluru, 560007, India

    Santhosh Kumar

  4. Orthopaedics Surgeon, Department of Orthopaedics, Health City Hospital Nagpur, Nagpur, 440010, India

    Anurag Kawale

Authors
  1. Vikas Kulshrestha
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  2. Munish Sood
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  3. Santhosh Kumar
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  4. Anurag Kawale
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Correspondence to Munish Sood.

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Kulshrestha, V., Sood, M., Kumar, S. et al. Original study: early patient-reported functional outcome of all-inside ACL reconstruction as compared to anteromedial portal technique. Eur J Orthop Surg Traumatol 31, 1477–1483 (2021). https://doi.org/10.1007/s00590-021-02912-6

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  • DOI: https://doi.org/10.1007/s00590-021-02912-6

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