All-Inside ACL Reconstruction

All-Inside ACL Reconstruction is an excellent minimally invasive surgical alternative to traditional ACL reconstruction surgery

Both traditional ACL reconstruction surgery and All-Inside ACL reconstruction surgery involve replacing the ACL with a tendon graft (either LARS ligaments, hamstring tendon, patellar tendon, cadaver graft). The difference between traditional ACL surgery and All-Inside ACL surgery is the approach taken, in particular the drilling of a tibial tunnel. Traditional ACL reconstruction techniques involve drilling a tunnel from the outer tibial cortex into the proximal tibia and knee joint. Through this tunnel the ACL graft is inserted and securely fixed onto the tibia. This tibial tunnel is a significant source of pain following ACL surgery as the peristeum over the tibial cortex is sensitive and a violation of this area is similar to the pain experienced with a fracture. 

However, with All-Inside ACL reconstruction such a tibial tunnel is not created. Instead a specialised tool called a reamer is used to create a tibial socket, which does not violate the tibial cortex. All-Inside ACL surgery also doesn’t involve any formal incisions, only three to four small arthroscopy incisions.


The advantages of All-Inside ACL surgery compared with traditional ACL reconstruction surgery include:

  • Less pain following surgery compared with traditional techniques
  • Small incisions and less scarring
  • Recovery from All-Inside ACL surgery is much faster than following traditional ACL surgery
  • Faster healing time resulting in being able to return to daily activities much quicker 
  • Due to the specialised instrumentation used, All-Inside ACL surgery can help to facilitate a more anatomic ACL reconstruction 


All-Inside ACL reconstruction is more difficult and technically demanding than traditional ACL surgical approaches. Professor Munjed Al Muderis is both experienced and proficient in this surgery.