ISAKOS: 2019 Congress in Cancun, Mexico

2019 ISAKOS Biennial Congress ePoster #769


Anterior Cruciate Ligament Reconstruction Using an All-Inside Short-Graft Technique versus a Conventional Hamstring Technique: A Prospective, Randomized Comparative Study with Two-Year Follow-Up

Panagiotis Kouloumentas, MD, Athens GREECE
Georgios K. Triantafyllopoulos, MD, MSc UNITED STATES
Efstratios Kavroudakis, MD, MSc, IOC DipSpPhy
Efstathios Charalampidis GREECE
Dimitris Kavroudakis, Prof., Lesvos GREECE

Metropolitan Hospital, Athens, GREECE

FDA Status Cleared


Anterior cruciate ligament reconstruction with an all-inside technique and a short, quadruped semitendinosus tendon autograft yields satisfactory results at 2 years compared to the conventional hamstring technique with a semitendinosus/gracilis tendon autograft.



Our aim was to compare the “all-inside technique” for anterior cruciate ligament (ACL) reconstruction using a short, quadrupled semitendinosus tendon (ST4) autograft and suspensory cortical fixation on both the femoral and tibial side versus the “conventional technique” using a semitendinosus/gracilis (ST/G) autograft fixed with a suspensory device on the femoral side and with an interference screw on the tibial side.


A total of 86 patients were enrolled and prospectively followed. Group A comprised 44 patients treated with the all-inside technique and Group B included 42 patients treated with the conventional ACL technique (52 males, 34 females; mean age, 28.7 ± 11.2 years). Patients completed the Tegner-Lysholm score, the International Knee Documentation Committee (IKDC) score, the Knee Injury and Osteoarthritis Score (KOOS) and the Knee Society Score (KSS) preoperatively and at 2 years postoperatively. Anterior tibial translation measurement (KT-1000 arthrometer) and isokinetic testing of the operative vs. non-operative limb were also conducted. A comparison of outcome measures between the two groups at 24 months was performed.


At 2 years, the Tegner-Lysholm, IKDC, KOOS and KSS scores between the two groups were similar. Anterior tibial translation between the operative and non-operative knee was also similar among the two groups. Patients of Group A had significantly better flexor peak torque, time-to-peak and total work at 180 degrees/sec, and significantly better isometric flexor/extensor ratio at 90 degrees/sec.


The all-inside ACL reconstruction with an ST4 autograft and cortical button fixation on both ends is a viable alternative to the conventional technique.