Comparison of Clinical Outcomes Between All-Inside and Complete Tibial Tunnel Techniques in Anterior Cruciate Ligament Reconstruction Among Patients With ACL Ruptures

NCT07023653 | Recruiting

• 1 other identifier: 24-07-0995
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 2

Brief Summary

This study aims to compare the functional outcomes of patients with ACL rupture following ACL reconstruction surgery using hamstring grafts, between the all-inside technique and the complete tibial tunnel technique. The hamstring graft, which serves as the tissue substitute for the damaged ACL, is harvested from the posterior thigh of the patient and used to replace the torn ligament during reconstruction

Conditions

Anterior Cruciate Ligament Rupture

Keywords

All-inside Techniques

Outcome Measures

Primary Outcomes (5)

• Tibial Translation

  Objective measurement of the anterior tibial translation relative to the femur will be performed using a rolimeter during the Lachman test.

  Before surgery, 3rd month, 6th month, 9th month, and 12 month after surgery

• Pain scale using Visual Analogue Scales

  Pain scale on the injured knee, where the minimum value is 0 = no pain, and the maximum value is 100 = severe pain. A higher scale means worse outcomes.

  Before surgery, 3rd month, 6th month, 9th month, and 12 month after surgery

• International Knee Documentation Comittee (IKDC) Score

  Knee Function Assessment

  Before surgery, 3rd month, 6th month, 9th month, and 12 month after surgery

• Tegner-Lysholm Score Knee Scoring Scale

  a tool to assess knee function

  Before surgery, 3rd month, 6th month, 9th month, and 12 month after surgery

• Hamstring Graft Diameter

  The thickness of the hamstring graft after harvesting and folding will be measured using a sizing block with various intra-operative hole sizes

  Intra-operative

Study Arms (2)

All-Inside Technique

ACTIVE COMPARATOR

Patients With ACL Ruptures will undergo ACL reconstruction surgery with All-inside techniques

Procedure: All-Inside Techniques

Complete Tibial Tunnel

ACTIVE COMPARATOR

Patients With ACL Ruptures will undergo ACL reconstruction surgery with complete tibial tunnel techniques

Procedure: Complete Tibial Tunnel techniques

Interventions

All-Inside Techniques PROCEDURE

All-inside ACL reconstruction technique avoids creating full-length bone tunnels. Instead, it uses retrograde drilling to form bone sockets, and the graft is secured with adjustable-loop suspensory fixation on both the femur and tibia.

All-Inside Technique

Complete Tibial Tunnel techniques PROCEDURE

Complete Tibial Tunnel Technique is a conventional technique for ACL reconstruction which involves the creation of full-length bone tunnels in the tibia for graft passage via an anterograde approach. Graft fixation is typically achieved using a bio-interference screw on the tibial side and a fixed-loop suspensory device on the femoral side

Complete Tibial Tunnel

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with anterior cruciate ligament rupture
• Patients within the age range of 18 to 65 years

You may not qualify if:

• Patients with Multiple Ligament Injuries in the Knee Joint
• Patients with a pregnancy condition
• Patients with Severe Osteochondral Defect (ICRS 4)
• Patients with signs of inflamation in knee joint

Sponsors & Collaborators

• Indonesia University: lead

Study Sites (2)

Indonesian University Hospital

Depok, Indonesia

RECRUITING

Cipto Mangunkusumo Hospital

Jakarta Pusat, Indonesia

RECRUITING

Related Publications (32)

• Kouloumentas P, Kavroudakis E, Charalampidis E, Kavroudakis D, Triantafyllopoulos GK. Superior knee flexor strength at 2 years with all-inside short-graft anterior cruciate ligament reconstruction vs a conventional hamstring technique. Knee Surg Sports Traumatol Arthrosc. 2019 Nov;27(11):3592-3598. doi: 10.1007/s00167-019-05456-9. Epub 2019 Mar 19.

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• Denti M, Bigoni M, Randelli P, Monteleone M, Cevenini A, Ghezzi A, Schiavone Panni A, Trevisan C. Graft-tunnel mismatch in endoscopic anterior cruciate ligament reconstruction. Intraoperative and cadaver measurement of the intra-articular graft length and the length of the patellar tendon. Knee Surg Sports Traumatol Arthrosc. 1998;6(3):165-8. doi: 10.1007/s001670050093.

  PMID: 9704323 BACKGROUND

• Meijer K, Saper M, Joyner P, Liu W, Andrews JR, Roth C. Minimizing Graft-Tunnel Mismatch in Allograft Anterior Cruciate Ligament Reconstruction Using Blumensaat's Line: A Cadaveric Study. Arthroscopy. 2018 Aug;34(8):2438-2443.e1. doi: 10.1016/j.arthro.2018.03.006. Epub 2018 May 3.

  PMID: 29730211 BACKGROUND

• Chiang ER, Ma HL, Wang ST, Hung SC, Liu CL, Chen TH. Hamstring graft sizes differ between Chinese and Caucasians. Knee Surg Sports Traumatol Arthrosc. 2012 May;20(5):916-21. doi: 10.1007/s00167-011-1653-3. Epub 2011 Aug 25.

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• Tang SP, Wan KH, Lee RH, Wong KK, Wong KK. Influence of hamstring autograft diameter on graft failure rate in Chinese population after anterior cruciate ligament reconstruction. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2020 Aug 12;22:45-48. doi: 10.1016/j.asmart.2020.07.005. eCollection 2020 Oct.

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• Colombet P, Graveleau N. An Anterior Cruciate Ligament Reconstruction Technique With 4-Strand Semitendinosus Grafts, Using Outside-In Tibial Tunnel Drilling and Suspensory Fixation Devices. Arthrosc Tech. 2015 Sep 28;4(5):e507-11. doi: 10.1016/j.eats.2015.05.014. eCollection 2015 Oct.

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• Takahashi T, Watanabe S, Ito T. A Surgical Technique for Anterior Cruciate Ligament Reconstruction Using Semitendinosus Graft: An All-Inside Transfemoral Approach. Arthrosc Tech. 2023 May 29;12(6):e975-e982. doi: 10.1016/j.eats.2023.02.035. eCollection 2023 Jun.

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• Jones PE, Schuett DJ. All-Inside Anterior Cruciate Ligament Reconstruction as a Salvage for Small or Attenuated Hamstring Grafts. Arthrosc Tech. 2018 Apr 9;7(5):e453-e457. doi: 10.1016/j.eats.2017.11.007. eCollection 2018 May.

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• Fritsch B, Figueroa F, Semay B. Graft Preparation Technique to Optimize Hamstring Graft Diameter for Anterior Cruciate Ligament Reconstruction. Arthrosc Tech. 2017 Nov 13;6(6):e2169-e2175. doi: 10.1016/j.eats.2017.08.011. eCollection 2017 Dec.

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• Rante SDT, Santoso A, Sibarani T, Utomo DN. All-inside vs. conventional method in anterior cruciate ligament (ACL) reconstruction: systematic review and meta-analysis. Indones J Biomed Sci. 2022;16(2):47-59.

  BACKGROUND

• Lubowitz JH, Schwartzberg R, Smith P. Randomized controlled trial comparing all-inside anterior cruciate ligament reconstruction technique with anterior cruciate ligament reconstruction with a full tibial tunnel. Arthroscopy. 2013 Jul;29(7):1195-200. doi: 10.1016/j.arthro.2013.04.009.

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• Lubowitz JH. No-tunnel anterior cruciate ligament reconstruction: the transtibial all-inside technique. Arthroscopy. 2006 Aug;22(8):900.e1-11. doi: 10.1016/j.arthro.2006.06.003.

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  PMID: 35337306 BACKGROUND

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  PMID: 21946441 BACKGROUND

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  PMID: 34158018 BACKGROUND

• Goyal T, Das L, Paul S, Choudhury AK, Sethy SS. Outcomes of retro-drilled all-inside tibial tunnel vs complete tibial tunnel techniques in anterior cruciate ligament reconstruction-a comparative study. Eur J Orthop Surg Traumatol. 2022 Apr;32(3):523-532. doi: 10.1007/s00590-021-03011-2. Epub 2021 May 24.

  PMID: 34028623 BACKGROUND

• Connaughton AJ, Geeslin AG, Uggen CW. All-inside ACL reconstruction: How does it compare to standard ACL reconstruction techniques? J Orthop. 2017 Mar 19;14(2):241-246. doi: 10.1016/j.jor.2017.03.002. eCollection 2017 Jun.

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• Bosco F, Giustra F, Ghirri A, Cacciola G, Masse A, Capella M. All-Inside Anterior Cruciate Ligament Reconstruction Technique: Tips and Tricks. J Clin Med. 2023 Sep 6;12(18):5793. doi: 10.3390/jcm12185793.

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• Evans S, Shaginaw J, Bartolozzi A. Acl reconstruction - it's all about timing. Int J Sports Phys Ther. 2014 Apr;9(2):268-73.

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• Samitier G, Marcano AI, Alentorn-Geli E, Cugat R, Farmer KW, Moser MW. Failure of Anterior Cruciate Ligament Reconstruction. Arch Bone Jt Surg. 2015 Oct;3(4):220-40.

  PMID: 26550585 BACKGROUND

• Deviandri R, van der Veen HC, Lubis AMT, Postma MJ, van den Akker-Scheek I. Translation, Cross-Cultural Adaptation, Validity, and Reliability of the Indonesian Version of the IKDC Subjective Knee Form. Orthop J Sports Med. 2021 Sep 29;9(9):23259671211038372. doi: 10.1177/23259671211038372. eCollection 2021 Sep.

  PMID: 34604432 BACKGROUND

• Deviandri R, van der Veen HC, Lubis AMT, Utoyo GA, van den Akker-Scheek I, Postma MJ. Burden and Cost of Anterior Cruciate Ligament Reconstruction and Reimbursement of Its Treatment in a Developing Country: An Observational Study in Indonesia. Clinicoecon Outcomes Res. 2022 Jul 17;14:479-486. doi: 10.2147/CEOR.S368840. eCollection 2022.

  PMID: 35872972 BACKGROUND

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries

Condition Hierarchy (Ancestors)

Knee Injuries; Leg Injuries; Wounds and Injuries

Study Officials

• Prof. Dr. dr. Andri M.T. Lubis SpOT (K)

  Indonesia University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Prof. Dr. dr. Andri M.T. Lubis SpOT (K)

CONTACT

+628161177078; andri_lubis@yahoo.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof. Dr. Andri M.T. Lubis, MD

Study Record Dates

• First Submitted: June 9, 2025
• First Posted: June 17, 2025
• Study Start: October 15, 2024
• Primary Completion: December 1, 2025
• Study Completion (Estimated): December 1, 2026
• Last Updated: June 17, 2025

Record last verified: 2025-06

Locations

ID (2)