Approximately two years ago or 100 surgeries ago, we began a technique that is termed an all inside ACL reconstruction. The advantage to the patient is it's incredibly cosmetic with four button hole size incisions around the knee but more importantly it's a durable ACL reconstruction that stands up to traditional methods.
We decided to change our technique after going to national meetings and seeing the data reported on this procedure. At first, it seemed technically demanding but we worked out the learning curve pretty quick so it became very reproducible for us and a procedure that we do in about an hour. The main advantage for me is we harvested one of the hamstring tendons and traditional hamstring surgery requires taking two. The reason we don't like to take two is it can weaken the hamstring tendon, which is important for ACL recovery.
