All-Inside Anterior Cruciate Ligament Reconstruction: A Minimally Invasive Bone Preserving Approach with Promising Functional Outcomes

Introduction: Anterior cruciate ligament (ACL) injury is a common knee ligament injury affecting young and physically active individuals. Arthroscopic ACL reconstruction is the standard treatment for symptomatic tears to restore knee stability and function. The all-inside ACL reconstruction technique using hamstring autograft has gained popularity because of its minimally invasive nature and preservation of bone stock. This study aimed to prospectively evaluate the short-term functional outcomes of all-inside ACL reconstruction using hamstring autograft in patients with complete ACL tears. Materials and Methods: This prospective study was conducted at Gandhi Medical College, Bhopal, and associated Hamidia Hospital. Thirty-six patients aged 18-50 years with clinically and radiologically confirmed ACL tears were included. All patients underwent arthroscopically assisted all-inside ACL reconstruction using hamstring autograft. Pre-operative evaluation included clinical examination, radiological assessment, and functional scoring using Lysholm-Tegner score, International Knee Documentation Committee (IKDC) score, and Visual Analog Scale. Patients were followed at 1, 3, and 6 months postoperatively to assess stability and functional outcomes. Results: Most patients were aged 18-29 years, and male patients predominated. Road traffic accidents were the most common mechanism of injury. Most surgeries were performed within 1-3 months after injury. The majority of grafts measured 6-6.5 cm in length with an 8 mm diameter. Post-operative evaluation showed negative Lachman, anterior drawer, and pivot shift tests in all patients, with no varus or valgus instability. Most patients achieved excellent or good Lysholm-Tegner scores, whereas IKDC grading showed normal or near-normal knee function in all cases. Conclusion: All-inside ACL reconstruction using hamstring autograft provides good short-term functional outcomes with restoration of knee stability in patients with complete ACL tears.