Pain evaluation after all-inside anterior cruciate ligament reconstruction and short term functional results of a prospective randomized study☆ , ☆☆

Abstract Purpose 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). Conclusion 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. Level of evidence I; Therapeutic study