All-inside ACL: retroconstruction controversies.
All-inside anterior cruciate ligament reconstruction is controversial because the technique is new; as a result, evidence-based clinical outcome studies have yet to be published. The purpose of this article is to consider the following controversies (considered alphabetically): anatomy, biomechanics, biology, bioabsorbables, divergence of the femoral interference screw, expansion or widening of tunnels, fixation, future considerations, graft choice, the learning curve, technique, tensioning, and tibia blow-out fracture. The technique should be learned in stages. In the opinion of the author, the history of sports medicine and arthroscopy has been a progression toward less invasive techniques. In the future, all-inside anterior cruciate ligament reconstruction techniques should become more simple and reproducible, and clinical outcomes must be analyzed with long-term follow-up.
Lubowitz
James H
JH
Taos Orthopaedic Institute Research Foundation, 1219-A Gusdorf Rd., Taos, NM 87571, USA. jlubowitz@kitcarson.net
D016118:Anterior Cruciate Ligament / Q000033:anatomy & histology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena / Q000502:physiology; D001863:Bone Screws; D050376:Bone-Patellar Tendon-Bone Grafting / Q000379:methods; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D009917:Orbital Fractures / Q000601:surgery; D009985:Orthopedics / Q000193:education; D019651:Plastic Surgery Procedures / Q000193:education / Q000379:methods*; D013977:Tibia / Q000601:surgery