A study published in The Knee journal in 2017 evaluated the outcomes of patients undergoing anterior cruciate ligament (ACL) reconstruction using a TransLateral single-bundle, all-inside hamstring technique. The procedure involved harvesting the semitendinosus tendon, quadrupling it, and securing it with adjustable suspensory fixation devices. Femoral and tibial sockets were created using a retrograde drill, and the graft was fixed and tensioned on both the tibia and femur.
The study included 108 patients with a mean age of 30.9 years, followed for an average of 49.8 months. Results showed significant improvements in Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm, and Tegner Activity Scale scores at two years postoperatively. Range of motion was restored by two years, and knee stability was confirmed with KT-1000 arthrometer measurements. The re-rupture rate was 6.5%, all occurring after significant postoperative trauma.
Professor Wilson’s Comments
“When we first came up with the concept of viewing from the medial side of the knee and working from the lateral side, I developed what I called the trans-lateral approach. At that time, ACL reconstructions were traditionally performed using the transtibial technique, where the femoral tunnel was created through the tibial tunnel. Later, the transportal approach emerged, using the medial portal—or even an accessory medial portal—to achieve more anatomic tunnel placement.
My trans-lateral concept, however, was unique: we viewed from the medial side and worked laterally. This approach became the foundation of the All-Inside ACL technique, which is now considered the gold standard. I performed the first live demonstration of this technique at the AGA Meeting in Garmisch, Germany, in 2010, and subsequently collaborated on refining the guides and devices that made the technique reproducible and widely adopted.
Today, the All-Inside ACL reconstruction—whether using a quadrupled semitendinosus, a quadriceps tendon, a patellar tendon, or an allograft—is recognized as the preferred approach worldwide. I’m very proud to have been the first to perform this live in Germany, in front of a challenging audience, and to see it become the standard for modern ACL surgery.”
The study concluded that the TransLateral all-inside ACL reconstruction technique provides good medium-term subjective and objective outcomes with a low complication and failure rate.Link to the article: Clinical Outcomes of Anatomic, All-Inside, Anterior Cruciate Ligament (Acl) Reconstruction
