Comparative study of the clinical efficacy of all-inside and traditional techniques in anterior cruciate ligament reconstruction

Bai-Jing An; Yao-Ting Wang; Zhe Zhao; Ming-Xin Wang; Geng-Yan Xing

doi:10.12998/wjcc.v11.i14.3195

Comparative study of the clinical efficacy of all-inside and traditional techniques in anterior cruciate ligament reconstruction

World J Clin Cases. 2023 May 16;11(14):3195-3203. doi: 10.12998/wjcc.v11.i14.3195.

Authors

Bai-Jing An¹, Yao-Ting Wang¹, Zhe Zhao¹, Ming-Xin Wang¹, Geng-Yan Xing²

Affiliations

¹ Department of Sports Medicine, The Fourth Medical Center of PLA General Hospital, Beijing 100000, China.
² Department of Sports Medicine, The Fourth Medical Center of PLA General Hospital, Beijing 100000, China. xinggengyan123@163.com.

Abstract

Background: Many studies have focused on the femoral tunnel technique and fixation method, but few studies have involved the tibial tunnel technique and fixation method. The all-inside technique is one of the new techniques that has been described in recent years. All-inside anterior cruciate ligament (ACL) reconstruction is based on a tibial socket instead of a full tunnel. This method has many potential advantages.

Aim: To compare clinical outcomes of knee ACL autograft reconstruction using all-inside quadrupled semitendinosus (AIST) and traditional hamstring tendon (TBT) techniques.

Methods: From January 2017 to October 2019, the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed, including 67 males and 13 females. The patients had an average age of 24.3 ± 3.1 years (age range: 18-33 years). The AIST technique was used in 42 patients and the TBT technique was used in 38 patients. The time between operation and injury, operative duration, postoperative visual analogue scale (VAS) score and knee functional recovery were recorded and compared between the two groups. The International Knee Documentation Committee (IKDC) and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.

Results: Eighty patients were followed for 24-36 mo, with an average follow-up duration of 27.5 ± 1.8 mo. There were no significant differences in the time between surgery and injury, operative duration, IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups. There were significant differences in VAS scores 1 d, 3 d, 7 d, 2 wk and 1 mo after surgery (P < 0.05). There was no significant difference in VAS score at 3 mo, 6 mo and 1 year after operation.

Conclusion: The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique, but the postoperative pain was less with the AIST technique. Thus, the AIST technique is an ideal treatment choice for ACL reconstruction.

Keywords: All-inside quadrupled semitendinosus; Anterior cruciate ligament reconstruction; Clinical curative effect; Traditional hamstring tendon; Visual analogue scale.