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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(03): e385-e392
DOI: 10.1055/s-0044-1786726
Artigo Original
Joelho

Comparison of the Functional Outcomes of Arthroscopic Anterior Cruciate Ligament Reconstruction through the All-inside and Outside-in Techniques: A Double-Blinded Randomized Controlled Trial

Article in several languages: português | English
Paulson Varghese
1   Departamento de Ortopedia, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Índia
,
Saroj Kumar Patra 
2   Departamento de Trauma e Emergência, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Índia
,
Gurudip Das
1   Departamento de Ortopedia, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Índia
,
Bishnu P. Patro
1   Departamento de Ortopedia, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Índia
,
Gunjar Jain
1   Departamento de Ortopedia, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Índia
,
Haridas M. P.
3   Departamento de Farmacologia, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Índia
› Author Affiliations Financial Support The authors declare that they have received no financial support from agencies in the public, private or non-profit sectors for the conduction of the present study.
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Abstract

Objective To compare the functional outcomes of anterior cruciate ligament (ACL) reconstruction with hamstring autograft (HA) through the all-inside (AI) technique with adjustable-loop cortical Endobutton (Smith & Nephew, Watford, Hertfordshire, England) on the sides of the femur and tibia and through the outside-in (OI) technique using an interference screw on the tibial side and a cortical Endobutton on the femoral side.

Materials and Methods The present is a double-blinded randomized controlled trial (RCT) of 44 patients undergoing arthroscopic ACL reconstruction from February 2019 to February 2022 in a tertiary care hospital. As per computer-based randomization, the patients were distributed into two groups: the AI and OI groups. Both groups were evaluated for 12 months using the Visual Analog Scale (VAS), the Lysholm Knee Scoring Scale, and part I (pain score) and part II (function score) of the Knee Society Score (KSS).

Results On postoperative day 2, the VAS score was significantly higher in the OI group (p = 0.0001), but insignificant (p = 0.807) at 6 weeks. At 3, 6, and 12 months of follow-up, the score on the Lysholm Knee Scoring Scale was significantly higher (p = 0.001) in the AI group. At 6 months, both parts of the KSS showed a significant difference, with the AI group presenting a better outcome (p = 0.04). However, at 12 months, the AI group presented a better score on part I of the KSS, but no differences were observed regarding part II.

Conclusion In a follow-up of 12 months, the patients submitted to the AI technique presented better outcome scores and pain relief than those submitted to the OI technique.

Keywords

anterior cruciate ligament - anterior cruciate ligament reconstruction - arthroscopy - postoperative complications - randomized controlled trials as topic - rupture

Work developed at the Department of Orthopedics, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India.




Publication History

Received: 04 June 2023

Accepted: 20 February 2024

Article published online:
22 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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