title: Pain evaluation after all-inside anterior cruciate ligament reconstruction and short term functional results of a prospective randomized study.
abstract: OBJECTIVE
  To assess post-operative pain in patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction by the all-inside technique.
  
  
  METHODS
  A prospective randomized comparative parallel trial was performed in 2010-2011 including all patients who underwent an ACL reconstruction in an orthopaedic department in accordance with the CONSORT statement 2010. Patients were randomized to the surgical procedure, all-inside or classical, and were blinded to the surgical technique. Primary evaluation criterion was pain assessed on the Visual Analogical Scale 1 month after surgery. Secondary parameters were analgesic consumption, tunnel positioning on X-ray according to Aglietti's criteria and functional evaluation at six months with IKDC score. None of the patients was lost to follow-up.
  
  
  RESULTS
  46 consecutive patients were included, 23 in each group, mean age 29.3±9 years. Two patients were excluded due to postoperative complications that required early revision surgery. Forty-four patients were analyzed, 22 in each group. At one month, the pain level was 3.2±5.5 for the all-inside group and 8.6±10 for the classical group, p=0.057 (95%CI 0.5-10.4). Postoperative analgesic consumption was similar. The position of the tibial tunnels was better with the all-inside method, p=0.002 (95%CI 1.9-6.6%). There was no significant difference in the mean IKDC subjective score at six months, p=0.92 (95%CI-9.7 to 9.2).
  
  
  CONCLUSIONS
  At one month, the pain level seemed lower in the all-inside group than in the classical group, at the limit of statistical significance because the study was underpowered. The all-inside technique is a reliable procedure with very good results for pain, stability and knee function.
  
  
  METHODS
  I; Therapeutic study.
authors.affiliation: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, F-92100 Boulogne-Billancourt, France; University Clinic of Orthopedics and Traumatology, R-400132 Cluj-Napoca, Romania.
authors.forename: Horea
authors.initials: H
authors.lastname: Benea
authors.affiliation: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, F-92100 Boulogne-Billancourt, France.
authors.forename: Henri
authors.initials: H
authors.lastname: d'Astorg
authors.affiliation: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, F-92100 Boulogne-Billancourt, France. Electronic address: klouche_shahnaz@yahoo.fr.
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Klouche
authors.affiliation: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, F-92100 Boulogne-Billancourt, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bauer
authors.affiliation: University Clinic of Orthopedics and Traumatology, R-400132 Cluj-Napoca, Romania.
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Tomoaia
authors.affiliation: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, F-92100 Boulogne-Billancourt, France; Université de Versailles Saint-Quentin, F-78035 Versailles, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Hardy
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D061646:Operative Time; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology*; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D011859:Radiography; D016037:Single-Blind Method; D013710:Tendons / Q000637:transplantation; D064232:Visual Analog Scale
chemical_list: D000700:Analgesics
keywords: ACL tear; All-inside technique; Pain