Grafts for Anterior Cruciate Ligament Reconstruction: Systematic Review and Meta-Analysis

Andrez, Tássio N.; Oliveira, Julia Martins de; D'Oliveira, Lívia Baptista

doi:10.1590/1413-785220223006e256048

Cited by 3 publications

(3 citation statements)

References 32 publications

(153 reference statements)

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“…Of the 2598 studies initially identified from the search strategy, a total of 50 systematic reviews (36 systematic reviews with meta‐analyses, 14 systematic reviews alone) were included in the final quality assessment (Figure 1) [1‐7, 10‐13, 16, 19, 21‐23, 25‐29, 31‐33, 35, 38‐42, 44, 46, 48, 52, 54, 58‐60, 65‐69, 71‐75, 77]. Cohen's κ Scores were 0.73, 0.75 and 0.74 at the title/abstract, full‐text screening and AMSTAR‐2 assessment stages, respectively, indicating substantial agreement at all phases of the review.…”

Section: Resultsmentioning

confidence: 99%

Evaluating the quality of systematic reviews of comparative studies in autograft‐based anterior cruciate ligament reconstruction using the AMSTAR‐2 tool: A systematic umbrella review

Sritharan,

Milantoni,

Abdel Khalik

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThere remains a lack of consensus around autograft selection in anterior cruciate ligament reconstruction (ACLR), though there is a large body of overlapping systematic reviews and meta‐analyses. Systematic reviews and their methodological quality were aimed to be further assessed, using a validated tool known as assessing the methodological quality of systematic reviews (AMSTAR‐2).MethodsMEDLINE, Embase and CENTRAL were searched from inception to 23 April 2023 for systematic reviews (with/without meta‐analysis) comparing primary ACLR autografts. A final quality rating from AMSTAR‐2 was provided for each study (‘critically low’, ‘low’, ‘moderate’ or ‘high’ quality). Correlational analyses were conducted for ratings in relation to study characteristics.ResultsTwo thousand five hundred and ninety‐eight studies were screened, and 50 studies were ultimately included. Twenty‐four studies (48%) were rated as ‘critically low’, 17 (34%) as ‘low’, seven (14%) as ‘moderate’ and two (4%) as ‘high’ quality. The least followed domains were reporting on sources of funding (1/50 studies), the impact of risk of bias on results of meta‐analyses (11/36 studies) and publication bias (17/36 studies). There was a significant increase in the frequency of studies graded as ‘moderate’ compared to ‘low’ or ‘critically low’ quality over time (p = 0.020).ConclusionThe methodological quality of systematic reviews comparing autografts in ACLR is low, with many studies being rated lower due to commonly absent aspects of systematic review methodology such as investigating sources of funding and publication bias. More recent studies were generally more likely to be of higher quality. Authors are advised to consult AMSTAR‐2 prior to conducting systematic reviews in ACLR.Level of Evidence: Level IV.

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Section: Resultsmentioning

confidence: 99%

Evaluating the quality of systematic reviews of comparative studies in autograft‐based anterior cruciate ligament reconstruction using the AMSTAR‐2 tool: A systematic umbrella review

Sritharan,

Milantoni,

Abdel Khalik

et al. 2024

Knee surg. sports traumatol. arthrosc.

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“…Latest review shows that QT and HT autografts have comparatively good results in ACLR without significant differences regarding function, pain, and rupture after surgical intervention [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction with Quadrupled Semitendinosus Graft or Synthetic Ligament: Knee Stability and Clinical Outcomes at Three Years Follow-Up

Moretti,

Cassano,

Caricato

et al. 2023

Advances in Orthopedics

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The incidence of anterior cruciate ligament reconstruction (ACLR) surgeries is increasing and graft choice is important for a rapid return to activity, especially in patients older than 30 years. The aim of this study is to compare in term of quality of life and knee stability of patients who undergone ACLR using quadrupled semitendinosus (ST4) graft against patients who undergone ACLR with synthetic ligaments. Thirty-nine patients undergoing ACLR were enrolled in the study and were divided into two groups: ACLR with synthetic ligaments-LARS (group A) and ACLR with quadrupled semitendinosus graft ST4 (group B). They underwent surgery at Policlinico di Bari Orthopedic Unit between January 2017 and January 2020. Group A was composed by nineteen patients (36.16 ± 4.41 mean age-years, 22.47 ± 2.63 mean BMI-kg/m2, 39.37 ± 10.05 mean time evaluation after surgery-months) and group B was composed by twenty patients (34.95 ± 3.59 mean age-years, 21.1 ± 2.88 mean BMI-kg/m2, 36.75 ± 8.69 mean time evaluation after surgery-months). For each patient, the following data were recorded: age; side of injury, BMI, date of surgery, anterior knee laxity with the arthrometer, and Lysholm knee scoring scale. Mean value of anterior tibial translation (ATT) in group A was 3.09 mm ± 0.65 and in group B was 2.66 mm ± 1.61 ( p value of 0.1139). Mann–-Whitney U test used to compare the Lysholm means values between groups showed a p value of 0.9307. LARS has comparable clinical and functional outcomes compared with hamstring autografts at short-term of 3 years follow-up. Level of Evidence: IV.

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“…On the flexors side, hamstring weakness was more prevalent and significant in short term observation of HT patients when compared to others. [16,17] Yet another important factor to be considered while choosing ACL graft are complication types and rates. The most common morbidity after ACLR is anterior knee pain which was proved to be significantly related with BPTB graft.…”

Section: Autograftsmentioning

confidence: 99%

The terror of athletes - Anterior Cruciate Ligament Reconstruction, grafts and moden techniques

Woźniak,

Jung,

Hedesz

et al. 2024

J Educ Health Sport

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Introduction The anterior cruciate ligament (ACL) is a prevalent sports-related injury, constituting nearly half of knee injuries. This narrative review explores the evolution of ACL reconstruction surgeries, emphasizing graft types and their pros and cons. Current state of knowledgeThe ideal ACL graft choice depends on factors like age, lifestyle, and demands. Autografts are the current standard, with the Quadriceps Tendon graft offering similar outcomes and fewer complications. Allografts are a secondary option for older, low-demand patients due to a shorter recovery period. Artificial grafts have limited use, lacking strong evidence for clinical advantages but may be considered for suturing torn ACL stumps and in cases were quick recovery is essential. Summary Contemporary orthopedic practitioners must possess comprehensive knowledge of various ACL reconstruction graft types to tailor interventions precisely to individual patient requirements. The selection of a graft should be rooted in a profound comprehension of patients' lifestyles, medical histories, and specific demands, thereby mitigating the subjective impact of any associated limitations for the patient.

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Grafts for Anterior Cruciate Ligament Reconstruction: Systematic Review and Meta-Analysis

Cited by 3 publications

References 32 publications

Evaluating the quality of systematic reviews of comparative studies in autograft‐based anterior cruciate ligament reconstruction using the AMSTAR‐2 tool: A systematic umbrella review

Evaluating the quality of systematic reviews of comparative studies in autograft‐based anterior cruciate ligament reconstruction using the AMSTAR‐2 tool: A systematic umbrella review

Anterior Cruciate Ligament Reconstruction with Quadrupled Semitendinosus Graft or Synthetic Ligament: Knee Stability and Clinical Outcomes at Three Years Follow-Up

The terror of athletes - Anterior Cruciate Ligament Reconstruction, grafts and moden techniques

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