All-inside technique in ACL reconstruction: mid-term clinical outcomes and comparison with AM technique (Hamstrings and
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ORIGINAL ARTICLE
All‑inside technique in ACL reconstruction: mid‑term clinical outcomes and comparison with AM technique (Hamstrings and BpTB grafts) Andrea Pautasso1 · Marcello Capella2 · Luca Barberis1 · Luca Drocco2 · Riccardo Giai Via1 · Alessandro Bistolfi2 · Alessandro Massè1,2 · Luigi Sabatini2 Received: 5 July 2020 / Accepted: 10 September 2020 © The Author(s) 2020
Abstract Purpose The aim of this study was to define the subjective and objective clinical results of all-inside surgical technique at a medium-term follow-up and to compare these results with those obtained from antero-medial (AM) ACL reconstruction technique using hamstrings (HS) or bone-patellar tendon-bone (BpTB) grafts to detect eventual superiority of one technique to another. Methods A retrospective analysis of routinely collected data was conducted. Inclusion criteria were ACL reconstruction through all-inside technique or AM technique with HS or BpTB performed between January 2015 and May 2018; age between 15 and 30 year old; minimum 24 months’ available follow-up. Exclusion criteria were contralateral ACL reconstruction; need for any other associated procedures during surgery. Clinical outcomes were assessed with KOOS, Lysholm, Tegner scores and KT-1000 device. Results According to the selection criteria, 157 patients were enrolled and divided subsequently into 3 groups: all-inside (51 patients), AM-HS (53 patients) and AM-BpTB (53 patients). A significant postoperative improvement of each score in all groups was detected. The mean KT-1000 was 3.1 ± 1.0 mm in all-inside group, while 3.3 ± 1.4 mm and 2.5 ± 0.4 mm in AM-HS and AM-BpTB groups, respectively. Comparing the results obtained, no statistically significant difference was found between the three techniques (p = 0.27). Statistically significant differences were highlighted in surgical duration: all-inside method was the longest (117′), followed by AM-BpTB surgery (101′) and AM-HS technique (87′). Conclusions The all-inside technique showed good postoperative results at medium-term follow-up. It could be a valuable solution for ACL reconstruction, especially in young patients due to its less invasiveness, despite surgical skills and time needed. Levels of evidence Level IV. Keywords ACL reconstruction · Hamstrings · Bone-patellar tendon-bone · All-inside technique · Antero-medial technique
* Andrea Pautasso [email protected]
Alessandro Massè [email protected]
Marcello Capella [email protected]
Luigi Sabatini [email protected]
Luca Barberis [email protected]
1
Luca Drocco [email protected]
University of Turin, Via Gianfranco Zuretti 29, 10126 Turin, Italy
2
Orthopaedic and Traumatology Department, Orthopaedic and Trauma Center, Città della Salute e della Scienza, University of Turin, Via Gianfranco Zuretti 29, 10126 Turin, Italy
Riccardo Giai Via [email protected] Alessandro Bistolfi [email protected]
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Introduction Anterior cruciate ligament (ACL) surgical reconstruction dates bac
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