Comparative Study of Functional and Clinical Outcomes of All-Inside Versus Conventional Arthroscopic Anterior Cruciate Ligament Reconstruction

Abstract

Background: Anterior cruciate ligament (ACL) injuries commonly affect young, physically active individuals and may lead to knee instability and functional impairment. All-inside arthroscopic ACL reconstruction has emerged as an alternative to conventional reconstruction, potentially offering reduced postoperative morbidity and improved early recovery. Aim: To compare the functional and clinical outcomes of all-inside versus conventional arthroscopic ACL reconstruction. Materials and Methods: This prospective comparative study included 70 patients with ACL injuries, divided into Group A (all-inside reconstruction, n = 35) and Group B (conventional reconstruction, n = 35). Patients were evaluated for operative parameters, postoperative pain using the Visual Analogue Scale (VAS), knee range of motion, Lysholm and International Knee Documentation Committee (IKDC) scores, clinical knee stability, and postoperative complications over 6 months. Results: Operative duration was longer in Group A (78.4 ± 12.6 versus 69.2 ± 11.8 minutes; p = 0.002), whereas blood loss was significantly lower (42.6 ± 12.4 versus 55.8 ± 15.2 mL; p<0.001). Group A demonstrated significantly lower VAS scores at 2 weeks (2.8 ± 0.9 versus 3.5 ± 1.0; p = 0.003). At 6 months, Lysholm scores (91.2 ± 5.8 versus 88.4 ± 6.5; p = 0.061) and IKDC scores (88.6 ± 6.2 versus 85.8 ± 6.8; p = 0.077) were comparable. Postoperative complications occurred in 14.3% and 25.7% of patients, respectively (p = 0.232). Conclusion: Both techniques demonstrated satisfactory functional outcomes and knee stability. All-inside reconstruction showed potential advantages in early postoperative recovery, although 6-month functional outcomes were comparable.

Keywords: Anterior cruciate ligament; All-inside ACL reconstruction; Conventional ACL reconstruction; Arthroscopy; Lysholm score; IKDC score; Knee stability.