All-Inside Anterior Cruciate Ligament Reconstruction With Accurate Measurement Technique

The all-inside anterior cruciate ligament reconstruction technique is characterized by closed bone sockets for anterior cruciate ligament graft passage and typically adopts suspensory fixation instead of screw fixation. Inaccurate determination of the intra-articular length (IAL) of the graft is associated with an elevated risk of graft "bottoming out" and excessive length consumption of the tibial sockets. Notably, the IAL is dependent on the patient's knee dimensions and intraoperative tunnel positioning, thus requiring individualized measurement. Herein, we propose an intraoperative method for accurate IAL measurement in all-inside anterior cruciate ligament reconstruction, which enables the creation of bone sockets with appropriate lengths based on individual IAL values. This technique effectively mitigates graft-tunnel mismatch and improves the stability of graft fixation, thereby optimizing the clinical outcomes of the all-inside anterior cruciate ligament reconstruction.