Anatomical anterior cruciate ligament reconstruction (ACLR) results in fewer rates of atraumatic graft rupture, and higher rates of rotatory knee stability: a meta-analysis

Eliya, Yousif; Nawar, Khaled; Rothrauff, Benjamin B.; Lesniak, Bryson P.; Musahl, Volker; de, Darren

doi:10.1136/jisakos-2020-000476

Cited by 16 publications

(15 citation statements)

References 80 publications

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“…The Anatomic Anterior Cruciate Ligament Reconstruction Scoring Checklist (AARSC) has been validated as a scale for evaluating the completeness of anatomic reconstruction techniques, with high inter-rater reliability, consisting of 17 items with a maximum score of 19 points (Table 1) [62]. A minimum score of 8 on the AARSC has been utilized by several studies as the threshold for anatomic ACL reconstruction [15,63,64].…”

Section: Discussionmentioning

confidence: 99%

“…techniques have demonstrated that anatomic reconstruction results in decreased anteroposterior translation and reduced rotatory knee instability on pivot shift testing [65]. Furthermore, there is a significant decrease in rotatory knee instability in anatomic ACL reconstruction compared with non-anatomic reconstruction, with overall comparable failure rates and subjective outcomes J o u r n a l P r e -p r o o f between the groups [64]. However, a significantly greater proportion of traumatic graft failure has been found in the anatomic group, whereas non-anatomic reconstruction results in higher rates of atraumatic graft ruptures.…”

Section: Randomized Control Studies Comparing Anatomic Acl Reconstruc...mentioning

confidence: 99%

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Anatomic anterior cruciate ligament reconstruction: Freddie Fu's paradigm

Fox¹,

Engler²,

Zsidai³

et al. 2023

Journal of ISAKOS

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Section: Discussionmentioning

confidence: 99%

Section: Randomized Control Studies Comparing Anatomic Acl Reconstruc...mentioning

confidence: 99%

Anatomic anterior cruciate ligament reconstruction: Freddie Fu's paradigm

Fox¹,

Engler²,

Zsidai³

et al. 2023

Journal of ISAKOS

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“…Furthermore, there is no agreement on what constitutes anatomical ACLR at this time. As it has been utilized in recent systematic reviews examining multiple clinical outcomes, the inclusion of anatomic categorization of ACLR based on a score of 8 on the AASRC checklist is an emerging trend in literature [22] [58].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of the anatomical double-bundle anterior cruciate ligament reconstruction compared with the single-bundle technique: A Systematic Review and Meta-analysis.

2023

Preprint

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Objective This meta-analysis aims to evaluate clinical outcomes of arthroscopic single-bundle (SB) versus anatomical double-bundle (ADB) anterior cruciate ligament (ACL) reconstruction in ACL-injured adults. With the synthesis of all accessible randomized controlled trials (RCTs), it was hypothesized that the ADB method is superior to the SB technique. Methods The PRISMA checklist’s instructions were followed. To identify RCTs that compared the SB and ADB treatments, a thorough literature search was conducted through electronic resources including PubMed, Embase, Cochrane library, and Web of Science. The methodological quality of each included study was assessed by two independent authors by the Cochrane Collaboration’s risk of bias tool. The ADB techniques of all included studies were screened by the AARSC to determine the eligibility of operation. Nine clinical outcomes were extracted to compare the two techniques. We used the Review Manager 5.3 to make this analysis. Results This meta-analysis included 20 randomized controlled studies comparing outcomes between ADB with SB techniques in ACL reconstruction. After a minimum follow-up of 12 months, the ADB technique was similar to SB technique in subjective clinical outcomes, including IKDC subjective score, Lysholm score, Tegner activity score. Similar results were also found in the objective outcomes, such as IKDC objective grade, Pivot-shift test, Lachman test, Side-to-side difference, and OA change. Conclusion In general, when the ACL reconstruction approach meets the minimal total AARSC score of eight, the ADB and SB techniques can result in similar subjective results and knee laxity. Level of evidence I.

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“…However, the inclusion of anatomic classification of ACLR based on a score of ≥ 8 on the AASRC checklist is an emerging trend in literature, as it has been used in recent systematic reviews assessing various clinical endpoints [10, 15, 35]. For instance, in a recent meta‐analysis of 36 studies, the use of anatomical ACLR demonstrated a significantly superior restoration of rotatory stability [15]. Similarly, a separate study using the Swedish National Knee Ligament Registry found that the performance of anatomical ACLR lowered the risk of revision surgery associated with AM portal drilling [10].…”

Section: Discussionmentioning

confidence: 99%

Anatomical double-bundle anterior cruciate ligament reconstruction moderately improved tegner scores over the long-term: a systematic review and meta-analysis of randomized controlled trials

Eliya

Qureshi

Kay

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeTo assess the effects of anatomical double‐bundle (DB) versus single‐bundle (SB) for anterior cruciate ligament (ACL) reconstruction in skeletally mature patients with ACL injuries. MethodsMEDLINE, EMBASE, and CENTRAL were searched from inception to February 7, 2022 were screened for randomized controlled trials. The Anatomic Anterior Cruciate Ligament Reconstruction Checklist was used to categorize studies as anatomic. A random‐effects meta‐analysis was conducted, with pooled results being summarized using mean difference (MD). Risk of Bias (RoB) was assessed using the RoB 2.0 tool. Certainty of evidence was rated using GRADE. ResultsA search of 1371 unique articles yielded eight eligible trials, representing 735 patients (360 DB, 375 SB) with mean (SD) age of 28.5 (2.86) years and follow‐up of 52.1 (36.2) months. Most trials had moderate to low RoB. Overall, DB was not significantly better than SB on Lysholm scores (MD = 0.52, 95% CI, − 1.80–2.85, p = 0.66; moderate certainty) or subjective International Knee Documentation Committee (IKDC) scores (MD = − 0.40, 95% CI, − 4.35–3.55, p = 0.84; moderate certainty). Tegner scores were significantly higher in SB than DB in the intermediate term (MD = − 0.72, 95% CI, − 1.10 to − 0.34, p = 0.0002; high certainty), while significantly higher in DB relative to SB in the long‐term (MD = 0.52, 95% CI, 0.02–1.03, p = 0.04; high certainty). ConclusionDB ACL reconstruction significantly improves Tegner scores relative to SB ACL reconstruction over the long‐term (t ≥ 5 years). Intermediate term Tegner scores favour SB reconstruction. In both durations, there was no clinically significant difference based on the pre‐specified minimal clinically important difference of 1.0 point. There were also no significant differences in IKDC or Lysholm scores. Surgeons should consider anatomical DB ACL reconstruction as a result of long‐term improvement in patient‐reported outcomes. Level of evidenceI.

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Anatomical anterior cruciate ligament reconstruction (ACLR) results in fewer rates of atraumatic graft rupture, and higher rates of rotatory knee stability: a meta-analysis

Cited by 16 publications

References 80 publications

Anatomic anterior cruciate ligament reconstruction: Freddie Fu's paradigm

Anatomic anterior cruciate ligament reconstruction: Freddie Fu's paradigm

Clinical outcomes of the anatomical double-bundle anterior cruciate ligament reconstruction compared with the single-bundle technique: A Systematic Review and Meta-analysis.

Anatomical double-bundle anterior cruciate ligament reconstruction moderately improved tegner scores over the long-term: a systematic review and meta-analysis of randomized controlled trials

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