Is augmentation the best solution in partial anterior cruciate ligament tears? A literature systematic review and meta-analysis

Bosco, Francesco; Giustra, Fortunato; Crivellaro, Michele; Via, Riccardo Giai; Lavia, Alessandro Dario; Capella, Marcello; Sabatini, Luigi; Risitano, Salvatore; Rovere, Giuseppe; Massè, Alessandro; Vaishya, Raju

doi:10.1016/j.jor.2022.11.018

Cited by 24 publications

(33 citation statements)

References 39 publications

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“…In particular, the knee is the most frequent location for osteoarthritis, as its prevalence in adults is around 6%, rising as high as 40% among the 70-to-74-year-olds [5][6][7]. Knee osteoarthritis thereby represents a burden for national health systems, as it can lead to serious disability caused by increasing pain and progressive articular stifness that may limit patients' autonomy and thereby have a negative impact on their quality of life [8][9][10][11][12]. Te therapeutic goal for those cases that sufer from mild-to-moderate knee osteoarthritis is to alleviate the signs and symptoms of the disease and, if possible, to slow its progression.…”

Section: Introductionmentioning

confidence: 99%

Is the Combination of Platelet-Rich Plasma and Hyaluronic Acid the Best Injective Treatment for Grade II-III Knee Osteoarthritis? A Prospective Study

Ciapini

Simonettii

Giuntoli

et al. 2023

Advances in Orthopedics

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Background. Knee osteoarthritis is a common disease with increasing incidence and prevalence in western countries. It can cause severe pain and functional limitations, thereby representing a threat for patients’ quality of life and a burden for national health systems. Intra-articular injections with hyaluronic acid (HA) and platelet-rich plasma (PRP) have been used for decades in order to reduce the symptoms caused by osteoarthritis. In recent years, a combination of HA and PRP has been introduced in clinical practice with the aim to minimize the clinical presentation of osteoarthritis and potentially delay articular degeneration. Materials and Methods. Sixty cases with grade II-III knee osteoarthritis according to the Kellgren–Lawrence classification were included in a prospective study, focused on the evaluation of clinical and functional outcomes after intra-articular knee injections. Cases were randomly divided into three groups. Twenty cases (Group A) were injected with HA, 20 (Group B) had PRP, and the remaining 20 (Group C) received a combination of HA and PRP. Basal WOMAC score and VAS score were recorded before the treatment and repeated within 3 and 6 months after the treatment. Results. At 6-month follow-up, Group C (PRP + HA) was the one with the lowest WOMAC and VAS mean values. It was also the only group that reported a reduction in the two values both in the first three months and in the following three months. No major complication was recorded. Conclusion. The combination of platelet-rich plasma and hyaluronic acid can be effective in the treatment of grade II-III knee osteoarthritis in a short-to-mid-term scenario. It represents an innovative and valuable alternative to the administration of its two components alone.

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Section: Introductionmentioning

confidence: 99%

Is the Combination of Platelet-Rich Plasma and Hyaluronic Acid the Best Injective Treatment for Grade II-III Knee Osteoarthritis? A Prospective Study

Ciapini

Simonettii

Giuntoli

et al. 2023

Advances in Orthopedics

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“…Recent studies have shown that 14.5% of patients with knee arthrofibrosis after an intra-articular knee injury undergo surgical treatment. The incidences of knee arthrofibrosis after total knee arthroplasty and anterior cruciate ligament reconstruction (ACLR) were about 5.3% and 4%, respectively [ 3 – 5 ]. However, up to 17% of patients underwent arthroscopic arthrolysis after multiple-ligament reconstruction [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Topical administration of tranexamic acid reduces postoperative blood loss and inflammatory response in knee arthroscopic arthrolysis: a retrospective comparative study

You

Yao

et al. 2023

BMC Musculoskelet Disord

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Background Knee arthroscopic arthrolysis serves as an effective treatment for knee arthrofibrosis. However, hemarthrosis is the most common complication in arthroscopic surgery, which has potential adverse effects on postoperative rehabilitation. The purpose of this study was to evaluate the effects of topical tranexamic acid (TXA) in knee arthroscopic arthrolysis. Methods A total of 87 patients with knee arthrofibrosis who underwent arthroscopic arthrolysis from September 2019 to June 2021 were eligible for this retrospective review. Patients in the TXA group (n = 47) received topical administration of TXA (50 mL, 10 mg/mL) at the end of the surgery, and patients in the control group (n = 40) received no TXA. The postoperative drainage volumes, hematologic levels, inflammatory marker levels, knee range of motion (ROM), visual analog scale (VAS) pain scores, Lysholm knee scores and complications were compared between the two groups. The curative effect of each group was calculated according to Judet’s criteria. Results The mean drainage volumes on postoperative day (POD) 1 and POD 2, and total drainage volume were significantly lower in the TXA group than in the control group (P < 0.001 for all). The TXA group had significantly lower postoperative CRP and IL-6 levels on POD 1 and POD 2, and at postoperative week (POW) 1 and POW 2 than the control group. The VAS pain scores in the TXA group were significantly lower on POD 1 and POD 2, and at POW 1 and POW 2 than those in the control group (P < 0.001 for all). Patients in the TXA group showed better postoperative ROM and Lysholm knee scores at POW 1 and POW 2. No patient had any complications such as deep venous thrombosis (DVT) or infection. The excellent and good rates of knee arthroscopic arthrolysis were comparable between the two groups at the sixth postoperative month (P = 0.536). Conclusions Topical administration of TXA in knee arthroscopic arthrolysis can reduce postoperative blood loss and inflammatory response, alleviate early postoperative pain, increase early postoperative knee ROM, and improve early postoperative knee function without increased risks.

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“…According to the above search strategy, 130 related literatures were initially retrieved,32 duplicate literatures were excluded by using the literature management software Endnote X9, 78 unrelated literatures were excluded by reviewing the title and abstract, and 6 literatures were excluded by reading the full text of the literature. Finally, 14 literatures were included (19,21,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). The speci c literature retrieval and exclusion process is shown in Fig.…”

Section: Article Selection Resultsmentioning

confidence: 99%

Is Remnant Preservation in Anterior Cruciate Ligament Reconstruction Superior to the Standard Technique? An overview of systematic reviews

Zhang,

Xiao,

Deng

et al. 2023

Preprint

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Background: Anterior cruciate ligament injury is a common knee joint injury. Anterior cruciate ligament reconstruction is the best way to treat anterior cruciate ligament injury. It may have certain advantages to retain the ligament stump during the operation, but the results of systematic evaluation on whether to retain the ligament stump are different. The conclusion is still controversial, and the quality needs to be strictly evaluated. Objective: To evaluate the methodological quality, risk of bias, reporting quality and evidence quality of the systematic review of remnant preservation in anterior cruciate ligament reconstruction, and to provide reference for clinical work. Methods: We systematically searched the system evaluations in 8 electronic databases, the languages were limited to Chinese and English, and the time limit was from the establishment of the database to June 2023. Two reviewers independently screened literature and extracted data. The methodological quality, risk of bias, reporting quality and quality of evidence were evaluated by AMSTAR-2, ROBIS, PRISMA and GRADE tools. Results: A total of 14 systematic reviews were included. The evaluation results showed that the methodological quality of the included systematic reviews was relatively low, of which 5 were low quality and 9 were critically low quality. A small number of systematic reviews were low risk of bias. The system evaluation reports are relatively complete, but the lack of program registration is a common problem. A total of 111 clinical evidence were extracted from the included systematic reviews. The quality of evidence was generally low, with only 7 high-quality evidence, 45 medium-quality evidence, and the rest were low and very low-quality evidence. Among the reasons for relegation, imprecision is the most common, followed by inconsistency and indirectness. Conclusion: The existing evidence shows that patients after anterior cruciate ligament reconstruction with remnant preservation have certain advantages in knee joint function, joint stability and proprioception recovery, which may be a more effective surgical method. At the same time, it may increase the incidence of postoperative complications and adverse reactions. The disadvantage should also be taken seriously. However, at present, the quality of evidence is generally low, and the reliability of the conclusion is insufficient. It still needs to be verified and further in-depth research is needed.

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Is augmentation the best solution in partial anterior cruciate ligament tears? A literature systematic review and meta-analysis

Cited by 24 publications

References 39 publications

Is the Combination of Platelet-Rich Plasma and Hyaluronic Acid the Best Injective Treatment for Grade II-III Knee Osteoarthritis? A Prospective Study

Is the Combination of Platelet-Rich Plasma and Hyaluronic Acid the Best Injective Treatment for Grade II-III Knee Osteoarthritis? A Prospective Study

Topical administration of tranexamic acid reduces postoperative blood loss and inflammatory response in knee arthroscopic arthrolysis: a retrospective comparative study

Is Remnant Preservation in Anterior Cruciate Ligament Reconstruction Superior to the Standard Technique? An overview of systematic reviews

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