Background:There has been a substantial increase in the amount of systematic reviews and meta-analyses published on the anterior cruciate ligament (ACL).Purpose:To quantify the number of systematic reviews and meta-analyses published on the ACL in the past decade and to provide an overall summary of this literature.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic review of all ACL-related systematic reviews and meta-analyses published between January 2004 and September 2014 was performed using PubMed, MEDLINE, and the Cochrane Database. Narrative reviews and non-English articles were excluded.Results:A total of 1031 articles were found, of which 240 met the inclusion criteria. Included articles were summarized and divided into 17 topics: anatomy, epidemiology, prevention, associated injuries, diagnosis, operative versus nonoperative management, graft choice, surgical technique, fixation methods, computer-assisted surgery, platelet-rich plasma, rehabilitation, return to play, outcomes assessment, arthritis, complications, and miscellaneous.Conclusion:A summary of systematic reviews on the ACL can supply the surgeon with a single source for the most up-to-date synthesis of the literature.

This meta-analysis demonstrated improved overall arthrometric stability and fewer graft ruptures using suspensory fixation compared with aperture fixation of a quadrupled hamstring tendon autograft in ACL reconstruction. There were no differences in IKDC, Lysholm, Lachman, and pivot-shift outcomes between suspensory and aperture fixation.

Objectives:Researching medical information is the third most popular activity online, and there are a variety of web-based symptom checker programs available to the patient. A recent study has demonstrated that a web-based program can generate an accurate differential diagnosis in 89% of ambulatory patients with knee pain based on a history entered by the patient. Despite the regularity of online symptom checking, the authors are not aware of any study that has evaluated a patient's ability to self-diagnose the cause of their knee pain based on the results of a diagnostic program. The purpose of this study was to determine the ability of a patient to select his or her own diagnosis after being supplied with a differential diagnosis generated by a web-based program for the patient's knee pain.Methods:A web-based program was created to collect a knee pain history and generate a differential diagnosis for ambulatory patients with knee pain. The diagnoses generated by the program were linked to informative content which was immediately available to the patient in order to allow them to learn more about each diagnosis. Prior to coming to their office appointment, the patient was given the link for the program. They entered their history into the program which then generated a list of most likely causes for the patient's knee pain based on their history. The program has the capability of generating 21 common knee diagnoses. After exploring the informative content, the patient selected which diagnosis or diagnoses they believed were the most likely cause of their pain. Despite the program generating a limited list, the patient had the ability to select from all 21 diagnoses capable of being generated by the program when selecting the diagnosis(es) they believed was the cause of their knee pain. Within days of completing the program, each patient was examined by a board-certified orthopaedic surgeon. The physician was blinded to the differential diagnosis generated by the program as well as the diagnosis(es) selected by the patient. A third party was responsible for comparing the diagnosis(es) generated by the program with that selected by the patient as well as the final diagnosis(es) determined by the physician. The diagnosis(es) provided by the physician were considered the correct diagnosis for the patient. The level of matching between the patient selected diagnosis and the physician's diagnosis determined the ability of the patient to correctly diagnose the cause of their knee pain.Results:Ninety-two males and 108 females, with an average age of 49 years (19-76) were analyzed for this study. Two hundred twenty-seven patients were excluded from analysis because they did not complete the entire program, 10 patients were excluded because they were under 18 years of age and 6 patients were excluded because they had a diagnosis other than one capable of being generated by the program. Patients selected an average of 2 diagnoses (1-9). The program generated an average of 6.6 diagnoses (2-13) per patient and each patient ...

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