الفهرس 
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Abstract
Despite the numerous controversies in anterior cruciate ligament (ACL) reconstruction, it is generally agreed that restoration of normal anatomy and control of abnormal tibial translation and rotation are of paramount importance. Modern techniques have allowed us to reproducibly achieve these goals while minimizing operative morbidity. In addition, new technology has afforded us with alternative methods of tunnel preparation and graft fixation.
These new approaches have the potential of improving tunnel position, allowing solid fixation, and providing customization of the reconstruction based on patient characteristics.
ALL-inside techniques has gained popularity in the past few years, as the use of sockets, rather than full bone tunnels, preserves bone which may be helpful if subsequent revision reconstruction is required or in the setting of multiple ligament reconstruction surgery. In addition, postoperative pain and swelling may be reduced. The Graft-Link technique using a single semitendinosus tendon is required for most cases allowing preservation of the gracilis tendon results in improved postoperative knee flexion strength and leaves this tendons available for subsequent or concurrent ligament reconstructions.
However all inside ACL reconstruction is technically demanding regarding graft preparation using graft link technique, socket creation, graft fixation and tensioning.
The aim of this study is to compare all-inside technique with the traditional BPTB which is considered a gold standard for many surgeons as the advantages of BPTB graft is related to the initial quality of fixation, high initial strength and stiffness, potential for bone-to-bone healing, better stability over time, improved rate of return to sport, and overall increased activity level.
from September 2016 to june 2018, a prospective randomized study was undergone to assess two groups of patient.
Fifty patients with ACL deficient knee underwent arthroscopically assisted anatomic single bundle (ASB) ACL reconstruction, 25 Patients done using All-inside technique and 25 patients using BPTB.
Preoperatively, no significant differences between the two groups were noted with respect to age, level of activity, degree of laxity.
A standardized rehabilitation program was used for both groups. Assessment of the patients was carried out by clinical assessment, Lysholm knee scores, the international knee documentation committee scale (IKDC)
Of the knees involved, 26 (52%) were right side and 24 (48%) were left. Age ranges from 18 to 35 years and the mean age was 22.48 ± 5.8 years and the main cause of ACL injury was by pivoting( 58%) and the second cause was during contact sport (24%). The average time between the injury and the surgical interference was 8.04 ± 4.7 months
Follow up on regular basis after reconstruction was done for one year postoperatively. Follow up was done weekly in the first month, then twice monthly for the next 2 months, then monthly for 9 month (total one year).
The overall results of the present study, as measured by the IKDC evaluation system after 12 months follow up, were 92% of BPTB patients (group A) had score A(normal knees) and 8% of the BPTB patients had score B(nearly normal knees). Regarding All- inside (group B ) 84% had score A and 16% had score B.
The final Final evaluation according to Lysholm score, the difference was found to be statistically insignificant between both groups.