Efficacy of Repair for ACL Injury: A Meta‑analysis of Randomized Controlled Trials

Abstract

We aim to compare the curative effect of primary repair for anterior cruciate ligament (ACL) injury with reconstruction and provide the reliable evidence for its clinical application. The literatures were searched in PubMed, EMBASE, Springer, and other medical literature databases published between January 1970 and June 2021. Basic characteristics, surgery technique, clinical outcome scores and physical examination results were recorded and evaluated. Seven randomized controlled trials (RCT) were eligible for inclusion. The results showed that there were no statistically significant differences between arthroscopic ACL repair and ACL reconstruction for Tegner, Lysholm, Lachman, KT-1000, range of motion (ROM), functional outcomes and reoperation rate (P > 0.05), even the result of IKDC scores showed that arthroscopic repair was better than reconstruction (P = 0.04). However, through the subgroup analysis, it was found that the short-term follow-up results of arthroscopic ACL repair were indeed better than those of open ACL repair. Therefore, we can assume that the arthroscopic ACL repair technique is an optional and promising surgical method to treat ACL injury.

Isometric Knee Muscle Strength and Patient-Reported Measures Five Years after Anterior Cruciate Ligament Reconstruction: Comparison of Single versus Dual Autograft Hamstring Tendon Harvesting

“…Finally, the clinical tools used could have some influence on our results. However, the KT1000 is the most used device to measure ATT [ 66 ], and the reliability of Microfet, the device used to measure isometric strength, is >0.95 [ 67 , 68 ].…”

Comparison of Clinical Outcomes Between Modern Augmented ACL Repair and Autograft ACL Reconstruction: A Systematic Review and Meta-analysis of Studies With Minimum 2-Year Follow-up

“…48 The second reason is the prevalence of arthroscopic surgery, which is less invasive and leads to higher postoperative activity function level, lower reoperation rates, and earlier start of rehabilitation than open arthrotomy. 29 Another important reason for the revisitation of primary repair is the invention of new surgical techniques to enhance the biomechanical properties of the repaired ACL (SAR, suture augmentation repair, DIS, IBLA, and BEAR).…”

“…Recent studies have reported varying findings regarding the outcomes of arthroscopic ACL repair compared with ACL reconstruction, with some studies indicating similar outcomes and others suggesting better or worse results in terms of mixed objective and patient-reported outcomes. 1,21,27,29,39,50,53 It is widely acknowledged in the academic community that this variability in outcomes may be attributed to the insufficient duration of follow-up. 24,39,46,49 In recent meta-analyses, most of the included studies had ≤2 years of follow-up, and almost no study reached 5 years of follow-up.…”

A deep learning approach for anterior cruciate ligament rupture localization on knee MR images

“…In the 1970s and 1980s, open primary ACL repair was commonly performed but was eventually abandoned due to poor surgical results and complications (Feagin and Curl, 1976;Taylor et al, 2009). With the development and application of arthroscopy, biotechnology, stronger internal fixation techniques, and more rational postoperative rehabilitation, ACL repair has received renewed attention from orthopedic surgeons (van der List and DiFelice, 2017; DiFelice and van der List, 2018; Mahapatra et al, 2018;Ahmad et al, 2019;Hoogeslag et al, 2019;Murray et al, 2020;Li, 2022). Isolated ACL repair has been reported using various techniques including suture anchor primary ACL repair, internal brace ligament augmentation, bridge-enhanced ACL repair (BEAR), and dynamic intraligamentary stabilization (DIS) methods (Heusdens, 2021).…”