All-Inside Anterior Cruciate Ligament Reconstruction
An arthroscopic procedure performed to replace a torn Anterior Cruciate Ligament (ACL) with a tendon graft. Two small incisions are made on the front of the knee. An arthroscopic camera and instruments are used to clear the torn ACL away from its bone attachment sites in the knee. A socket is drilled at the femoral attachment site from inside the knee. A third, very small, incision is made just below the knee and a specialized drill bit is used to drill a small hole to the tibial attachment site inside the knee. The tip of the drill bit flips to the side and reverse drills a socket in the tibia from inside the knee. The graft is then introduced into the knee using passing sutures that are shuttled through the sockets to the exterior of the leg. These sutures are tensioned bringing either end of the graft into the tunnels. Metal buttons attached to the sutures are seated on the outside of the bone and allow the graft to be secured in place.
Surgical Technique Video
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Common Questions About All-Inside Anterior Cruciate Ligament Reconstruction
What is All-Inside ACL Reconstruction?
All-Inside ACL reconstruction is a special technique of ACL reconstruction that refers to the entire procedure being done arthroscopically from inside the knee. Sockets are drilled in a reverse fashion from inside to out and therefore the cortical surface bone of the femur and tibia are preserved. Buttons are placed on the cortical bone to tension the graft.
Who should have an All-Inside ACL reconstruction?
All-inside technique is useful in patients who have soft or thin bone, who have had multiple ACL surgeries, or who would like the most minimal scarring.
Is All-Inside ACL technique superior to other techniques?
There is no data showing that it is clinically superior. However, there is high patient satisfaction with the decreased scarring and post-operative pain using this technique.