Clinical and Functional Comparison of Two Different Fixation Techniques in Anterior Cruciate Ligament Reconstruction: All-Inside Versus Anteromedial

Abstract

Objective: To compare the clinical and functional outcomes of two different graft fixation methods, all-inside and anteromedial (AM), for single-bundle anterior cruciate ligament (ACL) reconstruction techniques. Methods: Comparing the mid-term results of two groups, the prospectively recorded data of patients diagnosed with isolated ACL rupture between 2015 and 2016 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 AM portal [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 mean age and follow-up period were statistically equal between the two groups. The functional comparison of patients with Tegner and Lysholm knee and IKDC scores, showed no statistical difference 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 study showed that ACL reconstruction via the all-inside had functionally better anterior translation and similar rotational stability results compared with the AM portal technique. Level of Evidence III, Case Control Study.