All-Inside Versus Conventional Technique in Anterior Cruciate Ligament Reconstruction: A Randomized Clinical Trial

Anterior cruciate ligament (ACL) injuries significantly impact knee stability and function, especially in athletes. This randomized clinical trial compared the all-inside and conventional techniques for ACL reconstruction to determine differences in functional outcomes, surgical efficacy, and complication rates. Forty-eight patients with complete ACL tears were randomized into two groups: all-inside (n=24) and conventional (n=24). Functional outcomes were assessed using the Cincinnati and International Knee Documentation Committee (IKDC) scores at 6 and 18 months postoperatively. No significant differences in operative time or complication rates were observed. The mean Cincinnati scores at 6 months were 22.44 ± 5.20 (conventional) and 24.63 ± 7.10 (all-inside), while the 18-month scores were 34.84 ± 7.05 and 36.00 ± 7.62, respectively (p=0.325). IKDC scores showed similar trends, with no statistically significant differences at either interval (p=0.407). Subgroup analysis based on meniscal injury treatment (none, meniscectomy, or meniscal suture) also revealed no significant variation in functional outcomes. These findings suggest that both the all-inside and conventional techniques are effective and safe for ACL reconstruction, with comparable functional outcomes and low complication rates. While the all-inside method may offer theoretical advantages, further studies with larger sample sizes and longer follow-up are needed to establish long-term superiority.