All-Inside Patellar Tendon Anterior Cruciate Ligament Reconstruction

In the continued evolution of arthroscopic surgery for anterior cruciate ligament (ACL) reconstruction, the "All-Inside" technique has been developed in an attempt to further decrease surgical trauma. By replicating standard anatomic ACL reconstruction techniques, the RetroConstruction System (Arthrex, Naples, FL) eliminates tibial tunnels by creating "Retrodrilled" sockets. This All-Inside technique reduces the size and number of incisions and associated soft-tissue trauma, while eliminating the violation of distal cortices, thereby potentially decreasing patient morbidity, facilitating rehabilitation, and improving cosmesis. The technique is suitable for numerous graft options and can be used either in primary, revision augmentation, or multiligament reconstructions. The rationale and technique for All-Inside bone-patellar tendon-bone autograft or allograft single-bundle ACL reconstruction is presented.