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proximately two years ago our hundred surgeries ago we began a technique that is termed an all inside ACL reconstruction the advantage to the patient is its incredibly cosmetic with four buttonhole size incisions around the knee but more importantly its a durable ACL reconstruction that stands up to traditional methods so we decided to change our technique after going to national meetings and seeing the data reported on this procedure at first it seemed technically demanding but we worked out the learning curve pretty quick so it became very reproducible for us and a procedure that we do in about an hour the main advantage for me is we harvest one of the hamstring tendons and traditional hamstring surgery requires taking - the reason we dont like to take - is it can weaken the hamstring tendon which is important for ACL recovery you