‘All inside’ ACL reconstruction

Anterior Cruciate Ligament (ACL) tear is one of the most common knee injuries. Athletes who participate in high demand sports like netball, football, soccer & basketball are more likely to injure their ACL. If you have injured your ACL, you may require surgery to regain full function of your knee.

Mr Shalinder Sadiq performs ‘all inside’ ACL reconstruction. All inside ACL reconstruction is an excellent minimally invasive surgical option with several advantages over ‘traditional’ ACL reconstruction.


In traditional ACL reconstruction two hamstring tendons are harvested from the back of your thigh (semitendinosus and gracilis tendons). These two tendons are doubled to reconstruct your ACL.

Whereas in ‘all inside’ technique’ only one hamstring tendon (semitendinosus) is harvested for reconstruction. The gracilis tendon is left intact. The harvested semitendinosus tendon is quadrupled, which produces thicker sturdier graft for your ACL reconstruction.

All inside reconstruction technique allows inside out reaming to produce femoral and tibial sockets. This is achieved by the use of a highly specialized instrument called flipcutter. As the femoral socket is reamed by inside out technique, this avoids inadvertent injury to the articular cartilage of medial femoral condyle. In addition this technique is bone preserving on the shinbone (tibia), as ACL attachment on tibia is in a socket, rather than a tunnel.

The bony fixation of ACL graft by all inside technique is considered be stronger as it utilizes ‘cortical suspensory fixation’ in both thighbone (femur) and shinbone (tibia). Bulky fixation devices such as screws and bone staples are not required with this technique.


All inside ACL reconstruction is technically difficult and more demanding technique.
Please see All Inside ACL

Mr Shalinder Sadiq would be happy to discuss this technique in detail during your consultation.