Definition

The all-inside technique for anterior cruciate ligament reconstruction surgery is a minimally invasive procedure that replaces the ACL ligament with a graft. It's performed by making small poke-holes in the knee and without making any large incisions.

Alternative Names

• All-Inside ACL RetroConstruction

Who is a Candidate?

People who have knees that:

• Are unstable
• Tend to give out during activities
• Make them incapable of playing sports
• Pop at the time of injury
• Have redness and swelling shortly after the injury
• Buckle, lock or give out during physical activity

Benefits of the All-Inside Technique for ACL Reconstruction:

• There are no large incisions in the knee
• Re-establishes leg control
• Knee will have a normal range of motion
• Short rehabilitation and recovery time
• Walking without a limp sooner
• Decrease in post-operative pain
• Restore normal stability in the knee
• Limited loss of function in the knee

How is the All-Inside Technique for ACL Reconstruction performed?

The ACL is a ligament in the center of the knee that prevents the shin bone (tibia) from moving forward on the femur (thigh bone). The ACL ligament prevents the knee from being stretched or straightened beyond its normal limits. A tear of this ligament can cause the knee to give way during physical activity. An ACL injury usually involves a tear or separation of the ACL ligament from the bone. If a torn ACL is left untreated, cartilage damage and early arthritis may occur.

ACL reconstruction has evolved from an open procedure to an arthroscopically-assisted technique, by inserting a camera into the knee to view on a monitor. The arthroscopically-assisted technique reduces patient morbidity and improves rehabilitation time. However, ACL reconstruction has now been taken to the next level with the all-inside ACL reconstruction approach. These improvements and advancements have resulted in less pain and stiffness, fewer complications, and faster recovery time for the patient.

The all-inside ACL reconstruction approach secures the graft (portion of living tissue) into place. The graft is preassembled and ready to implant. The doctor will double fix the graft. There are 10mm tunnels made to insert screws. Putting the screws in the direction of the graft helps to pull the graft down into the tunnel. The doctor then extends the patient’s leg to properly tighten the graft.

Recovery/Rehabilitation

One of the main priorities after ACL reconstruction is to regain the knees range of motion. Establishing a good strengthening program is vital for a successful recovery. Crutches are usually needed for at least a week or two, with gradual progression to one crutch and finally to independent walking.

2/6/2009