All Inside ACL Reconstruction Procedure

all inside ACL reconstruction

Your knees are pivotal in your everyday life, supporting your mobility, balance, and overall well-being. When an Anterior Cruciate Ligament (ACL) gets injured and disrupts joint stability, exploring treatment options and understanding recovery becomes essential. 

In this comprehensive blog, we’ll delve deep into the world of All-inside ACL reconstruction—a surgical procedure designed to restore strength, stability, and function to the knee joint.

Understanding ACL Injuries

Anterior Cruciate Ligament (ACL) injury is a type of knee injury that involves damage to the ACL, one of the four major ligaments in the knee joint. 

ACL is a thick connective tissue band that connects two bones- the femur (thigh bone) and the tibia (shin bone). It gives protection and stability to the knee while the leg rotates.

ACL is prone to injuries, resulting in knee instability, pain, swelling, and difficulty with activities requiring knee stability.

Symptoms of ACL Injury

An ACL injury can lead to a variety of symptoms, the severity of which may differ based on the extent of the injury. Common symptoms of an ACL injury include:

  • Sudden and severe pain
  • Swelling of the knee joint
  • Laxity in the knee joint
  • A feeling of instability in the knee
  • Difficulty while walking, running, or walking on an uneven surface or inclined surface

What is Involved in All inside ACL Reconstruction Surgery?

All-inside ACL reconstruction surgery is an advanced and minimally invasive surgical procedure designed to repair a torn or damaged ACL, a crucial ligament in the knee joint. 

In early ACL reconstruction techniques, large incisions were required to repair tears, leading to more scarring. 

Now, the All-inside ACL reconstruction procedure is less invasive and more efficient than previous techniques and uses smaller incisions inside the knee rather than large incisions. 

Traditional ACL Reconstruction vs. All Inside ACL Reconstruction

All Inside ACL reconstruction is an improvement over the traditional ACL reconstruction surgical technique used to repair a torn or ruptured ACL in the knee. Here is the comparison between the two-

Traditional ACL reconstruction 

All inside ACL reconstruction

Involves larger incisions

Minimally invasive approach with smaller incisions

Longer hospital stay

Shorter hospital stay

Slower recovery

Potentially faster activity

Larger incisions lead to more scarring

Smaller incisions lead to less scarring

Usually more postoperative pain

Less postoperative pain

Patients should have a detailed discussion with their orthopaedic surgeon to determine which technique best suits their circumstances. 

Both procedures can be highly effective when performed by skilled surgeons, and the primary goal is to achieve a successful outcome with restored knee stability and function. 

All-Inside ACL Reconstruction Procedure

Here is a step-by-step overview of the all-inside ACL reconstruction procedure:


  • Before the surgery, a thorough evaluation is conducted, which includes a physical examination, a review of medical history, and diagnostic imaging, such as an MRI, to assess the extent of the ACL injury and any associated damage.
  • The procedure is typically conducted under general anaesthesia to ensure the patient’s comfort during the surgery.
  • The surgeon selects the appropriate graft and prepares to create a new ligament for ACL tear treatment. Common graft options include patellar tendon and hamstring tendon. The graft can be harvested from the patient’s own body or from a donor.

During the procedure

  • The surgeon makes small keyhole-sized incisions around the knee. 
  • The surgeon creates small tunnels in the tibia and femur at the anatomical location of the old ligament’s attachment points. 
  • Most of the procedure is done through keyhole surgery or arthroscopy. The majority of the old ACL is removed to make room for the new graft.
  • The new graft ligament is then threaded through the tunnels with the help of a small metal button on the femur bone and a similar button at the shin bone end. 
  • The internal knee brace or tape may be placed within the knee joint to provide additional support to the reconstructed ACL. 
  • The small incisions are closed with sutures, and a sterile dressing is placed to cover the surgical site.


all inside ACL reconstruction

Recovering From All-Inside ACL Reconstruction Surgery

Recovering from all-inside ACL reconstruction surgery is a crucial process that requires care.

  • Following the procedure, you will be given crutches and a brace to help you walk right after the surgery. 
  • Physical therapy is initiated to help aid in the recovery process, focusing on restoring strength, stability, and knee mobility.
  • Patients typically have regular follow-up appointments with their orthopaedic surgeon to monitor their recovery, assess graft healing, and adjust the rehabilitation plan as needed.
  • Return to activities, including sports, would not normally occur before six months after surgery, and return to contact pivoting sports would be around 12 months after surgery.

When is ACL Reconstruction Surgery Recommended

Your doctor may suggest ACL surgery in the following cases:

  • Injury- Adults in their day-to-day lives may suffer severe ACL injuries due to heavy labour or persistent knee movements over a long period. Athletes who need to pivot, turn, or twist may also need ACL surgery after suffering accidental knee injuries.
  • Functional instability- If you face ongoing knee instability that hinders your day-to-day activities despite undergoing conservative treatment such as physiotherapy.

When You Delay Getting ACL Treatment

Delaying ACL treatment may result in the progression of ACL injury to a complete tear, making it less likely to heal naturally without any surgical intervention.

  • Partial ACL Tear- If you delay the treatment, it can worsen the injury, leading to a complete ACL tear. As a result, you will lose your chance of healing without surgery, and ACL reconstruction surgery may become necessary.
  • Complete ACL Tear- Delaying treatment for an extended period can lead to knee cartilage, meniscus, and thigh muscle degeneration. With the torn ACL, the knee undergoes rapid degeneration, leading to the early onset of secondary osteoarthritis, which may require total knee replacement surgery. 

Consult Dr Rik Kundra, for all your knee issues!

If you are experiencing ACL issues and are considering an ACL reconstruction procedure, it’s important to consult a medical professional specialising in orthopaedics. 

Dr. Rik Kundra is a highly qualified and experienced orthopaedic surgeon who can provide expert guidance on the best treatment options for your condition.

Remember, seeking timely medical advice is crucial when dealing with ACL injuries. Book an appointment now!


How does ACL injury occur?

An ACL tear can occur during non-contact trauma or a direct blow to the knee. 

ACL injuries most commonly occur during physical activity involving jumping and landing on the foot with your knee collapsing inwards, pivoting and cutting movements, and sudden twisting and turning.

What should I do if I think I have injured my ACL?

If you suspect you have injured your ACL, stop your physical activity and take a rest. 

Try PRICE therapy, which means protection, rest, ice, compression, and elevation. Seek medical attention for further evaluation and management.

What are some methods to reduce ACL injury risk?

Reducing the risk of ACL injuries involves techniques like strength training, core strengthening, proper warmup, and increasing awareness of movements that can put stress on the ACL.


All content and media on this page are created and published for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Meet Dr. Rik personally for appropriate medical diagnosis and advice.

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