IMR Press / FBL / Volume 27 / Issue 3 / DOI: 10.31083/j.fbl2703091
Open Access Review
All-Inside Anterior Cruciate Ligament Reconstruction: A Review of Advance and Trends
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1 Department of Orthopaedics, Xiangya Hospital of Central South University, 410008 Changsha, Hunan, China
2 National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, 410008 Changsha, Hunan, China
*Correspondence: (Yu-sheng Li); (Wen-feng Xiao)
Academic Editors: Emerito Carlos Rodriguez-Merchan and Viviana di Giacomo
Front. Biosci. (Landmark Ed) 2022, 27(3), 91;
Submitted: 4 November 2021 | Revised: 14 February 2022 | Accepted: 23 February 2022 | Published: 8 March 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Anterior cruciate ligament (ACL) injury is a common disease in orthopedics and mostly occurs as a noncontact injury in athletes. Patients’ knee joint stability, which is crucial to their athletic ability, cannot be restored through conservative treatment; it can only be restored through ACLR (ACL reconstruction) surgery. The surgical techniques of ACLR are constantly evolving, from bone tendon bone (BTB) grafting combined with interface screw fixation to hamstring tendon autograft or allogeneic tendon and of suspension device constructs. In particular, the currently prevalent all-inside technique featuring good cosmetic results and quick recovery of early functions not only ensures the stable fixation of grafts but also reduces surgical trauma. This review compares the advantages and disadvantages of different aspects of all-inside ACLR, including graft selection and preparation, bone socket reconstruction, fixation methods, and surgical technique effects and limitations. It has been found that the all-inside technique excels both anatomically and clinically but still requires further development. Besides, it has some limitations, and high-quality randomized controlled trials are still required to compare the long-term effects of the all-inside technique and other ACLR techniques.

ACL reconstruction
Fig. 1.
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