Clinical And Functional Comparison Of Anterior Cruciate Ligament Reconstruction With Two Different Fixation Techniques: Single Bundle Versus All-Inside

Abstract

Introduction: The All-inside ACL reconstruction procedure features some distinguished components like closed-socket tunnels with less bone expulsion, double suspensory fixation and smaller incisions. We aimed to compare the clinical and functional outcomes of two different graft fixation methods via all-inside and single-bundle anterior cruciate ligament (ACL) reconstruction techniques.

Methods: To compare the outcome of two different groups, the prospectively recorded data of patients diagnosed with isolated ACL rupture between 2022 and 2023 were reviewed retrospectively. Two groups of patients who underwent unilateral isolated ACL reconstruction via two different tibial fixation techniques (19 patients with all-inside [Group 1]; 20 patients with single-bundle [Group 2]) from the same institution were enrolled as the study group. The patients were called for the final follow-up and evaluated for symptoms, knee stability (Lachman test, pivot shift test, and KT-1000 arthrometer analysis), and functional scores (Tegner and Lysholm knee scoring scale, International Knee Documentation Committee (IKDC) subjective knee score and visual analog scale [VAS]).

Results: The follow-up period and mean age were not statistically different between the two groups. In the functional comparison of patients with Tegner and Lysholm knee and IKDC scores, no statistical difference were found at the mid-term follow-up period. In the clinical assessment of the operated knees, based on the Lachman test and KT-1000 arthrometer, the anterior translation results in group 1 were better than those in group 2, which was statistically significant. However, we obtained similar pivot shift test results in both groups.

Conclusion: The present study showed that ACL reconstruction via the all-inside technique had functionally better anterior translation and similar rotational stability results compared with the single-bundle technique with tibia interference screw fixation.

Level of Evidence: Level III case control study.