Horea Benea1, Henri d'Astorg2, Shahnaz Klouche3, Thomas Bauer2, Gheorghe Tomoaia4, Philippe Hardy5. 1. Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, F-92100 Boulogne-Billancourt, France; University Clinic of Orthopedics and Traumatology, R-400132 Cluj-Napoca, Romania. 2. Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, F-92100 Boulogne-Billancourt, France. 3. Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, F-92100 Boulogne-Billancourt, France. Electronic address: klouche_shahnaz@yahoo.fr. 4. University Clinic of Orthopedics and Traumatology, R-400132 Cluj-Napoca, Romania. 5. Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, F-92100 Boulogne-Billancourt, France; Université de Versailles Saint-Quentin, F-78035 Versailles, France.
Abstract
PURPOSE: To assess post-operative pain in patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction by the all-inside technique. METHODS: A prospective randomized comparative parallel trial was performed in 2010-2011 including all patients who underwent an ACL reconstruction in an orthopaedic department in accordance with the CONSORT statement 2010. Patients were randomized to the surgical procedure, all-inside or classical, and were blinded to the surgical technique. Primary evaluation criterion was pain assessed on the Visual Analogical Scale 1 month after surgery. Secondary parameters were analgesic consumption, tunnel positioning on X-ray according to Aglietti's criteria and functional evaluation at six months with IKDC score. None of the patients was lost to follow-up. RESULTS:46 consecutive patients were included, 23 in each group, mean age 29.3±9 years. Two patients were excluded due to postoperative complications that required early revision surgery. Forty-four patients were analyzed, 22 in each group. At one month, the pain level was 3.2±5.5 for the all-inside group and 8.6±10 for the classical group, p=0.057 (95%CI 0.5-10.4). Postoperative analgesic consumption was similar. The position of the tibial tunnels was better with the all-inside method, p=0.002 (95%CI 1.9-6.6%). There was no significant difference in the mean IKDC subjective score at six months, p=0.92 (95%CI-9.7 to 9.2). CONCLUSION: At one month, the pain level seemed lower in the all-inside group than in the classical group, at the limit of statistical significance because the study was underpowered. The all-inside technique is a reliable procedure with very good results for pain, stability and knee function. LEVEL OF EVIDENCE: I; Therapeutic study.
RCT Entities:
PURPOSE: To assess post-operative pain in patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction by the all-inside technique. METHODS: A prospective randomized comparative parallel trial was performed in 2010-2011 including all patients who underwent an ACL reconstruction in an orthopaedic department in accordance with the CONSORT statement 2010. Patients were randomized to the surgical procedure, all-inside or classical, and were blinded to the surgical technique. Primary evaluation criterion was pain assessed on the Visual Analogical Scale 1 month after surgery. Secondary parameters were analgesic consumption, tunnel positioning on X-ray according to Aglietti's criteria and functional evaluation at six months with IKDC score. None of the patients was lost to follow-up. RESULTS: 46 consecutive patients were included, 23 in each group, mean age 29.3±9 years. Two patients were excluded due to postoperative complications that required early revision surgery. Forty-four patients were analyzed, 22 in each group. At one month, the pain level was 3.2±5.5 for the all-inside group and 8.6±10 for the classical group, p=0.057 (95%CI 0.5-10.4). Postoperative analgesic consumption was similar. The position of the tibial tunnels was better with the all-inside method, p=0.002 (95%CI 1.9-6.6%). There was no significant difference in the mean IKDC subjective score at six months, p=0.92 (95%CI-9.7 to 9.2). CONCLUSION: At one month, the pain level seemed lower in the all-inside group than in the classical group, at the limit of statistical significance because the study was underpowered. The all-inside technique is a reliable procedure with very good results for pain, stability and knee function. LEVEL OF EVIDENCE: I; Therapeutic study.
Authors: Fernando C Rezende; Vinícius Y Moraes; Carlos Es Franciozi; Pedro Debieux; Marcus V Luzo; João Carlos Belloti Journal: Cochrane Database Syst Rev Date: 2017-12-15
Authors: Marco Cuzzolin; Davide Previtali; Marco Delcogliano; Giuseppe Filardo; Christian Candrian; Alberto Grassi Journal: Orthop J Sports Med Date: 2021-07-12