Purpose
The purpose of this investigation was to compare the clinical effectiveness of full-tunnel
anterior cruciate ligament (ACL) reconstructive surgery with all-inside ACL reconstruction.
Methods
After statistical power analysis was performed and institutional review board approval
and patient informed consent were obtained, 150 patients having ACL reconstruction
were prospectively randomized to an all-inside or full–tibial tunnel technique. Outcome
(International Knee Documentation Committee [IKDC] Knee Examination Form, IKDC Subjective
Knee Evaluation Form, Knee Society Score [KSS], Short Form 12 [SF-12] score, femoral
or tibial tunnel or socket widening, narcotic consumption, and visual analog scale
[VAS] pain score compared with baseline) was measured and recorded preoperatively
and at various postoperative time points with a minimum follow-up of 2 years.
Results
There were no differences between groups with regard to IKDC Knee Examination Form,
IKDC Subjective Knee Evaluation Form, KSS score, SF-12 score, or femoral socket or
tibial tunnel or socket widening, or narcotic consumption. The VAS pain score compared
with baseline was significantly lower for the all-inside technique on day 1, on day
7, at 1.5 weeks, and at 24 months.
Conclusions
The null hypothesis (no difference between all-inside ACL reconstruction and ACL reconstruction
with a full tibial tunnel) is supported for IKDC scores, KSS score, SF-12 score, narcotic
consumption, and tibial and femoral widening, whereas all-inside ACL reconstruction
results in a lower VAS pain score compared with baseline.
Level of Evidence
Level I, randomized controlled clinical trial with greater than 80% patient follow-up
2 years postoperatively.
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Article info
Publication history
Accepted:
April 10,
2013
Received:
August 16,
2012
Footnotes
The authors report the following potential conflict of interest or source of funding in relation to this article: Arthrex. Columbia Orthopaedic Group—Research. Monies paid to support research staff time and effort for data collection on follow-up plus administrative application.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
