A systematic review on all-inside anterior crucinate ligament reconstruction

Background: In this era, orthopaedic surgery moves towards less invasive procedures and especially focuses on patient satisfaction. The all-inside technique (AIT) emerges as a promising alternative, however still there is controversy regarding this surgical procedure.Objectives: The aim of the present systematic review was to compare the surgical outcomes of all-inside techniques in terms of function, knee stability, graft failure, and further bone tunnel widening. Methods: This systematic review was carried out across various databases, including Google Scholar, PubMed, the Cochran library, Scopus, Web of Science, Embase, and Wiley. The available studies were included from last 10 years database from 2014 to 2024. Additionally, we evaluated the included studies using Revman 5.4 to analyze a risk of bias, study design, and methodological quality.Results: In this review, approximately 17 randomized clinical trials (RCTs) were incorporated. After the thorough analysis, we reported that, the gender information revealed in 15 studies in which 512 (71.91%) were male and 200 (28.08%) were female. Moreover, the mean age of participants was 27.86 years. Out of 17 studies, 14 of them used AIT to treat ACL reconstruction (ACLR). In the included studies, a total of 675 cases were managed with AIT. Out of these cases, 582 patients received a semitendinosus tendon graft, while the remaining 184 patients were given an autograft.Conclusion: Findings of the present study indicate that AIT preserves bony tissue and the gracilis tendon, resulting in reduced postoperative pain and increased knee flexor strength, with outcomes comparable to other surgical process. Therefore, all-inside anterior cruciate ligament reconstruction can be used as a good medium in terms of subjective and objective outcomes with a minimum complication.