A Systematic Summary of Systematic Reviews on the Topic of the Anterior Cruciate Ligament

Anderson, Michael J.; Browning, William M.; Urband, Christopher E.; Kluczynski, Melissa A.; Bisson, Leslie J.

doi:10.1177/2325967116634074

Cited by 158 publications

(144 citation statements)

References 241 publications

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“…There is no clear evidence that supervised rehabilitation after ACLR will result in superior outcomes compared to minimally supervised rehabilitation (Anderson, Browning, Urband, Kluczynski, & Bisson, 2016;Lobb et al, 2012), which may have contributed to low physiotherapy treatment numbers in the current study. Selected groups of patients, including young, athletic people, may achieve acceptable outcomes after ACLR with a minimally supervised rehabilitation programme involving fewer than 10 physiotherapy treatments over three to 12 months (Feller, Webster, Taylor, Payne, & Pizzari, 2004;Grant & Mohtadi, 2010;Hohmann, Tetsworth, & Bryant, 2011).…”

Section: Duration and Quantity Of Physiotherapy Treatmentmentioning

confidence: 72%

“…Almost half of the Surgery Group proceeded to ACLR within 90 days of injury, and 80% within 180 days of injury. There is no accepted definition for early or delayed ACLR (Beynnon et al, 2005), with "early" defined as between two days and seven months of DOI, and "delayed" as between three weeks and 24 years (Anderson et al, 2016). There are equivocal differences in outcomes between patients undergoing early verses delayed ACLR (Anderson et al, 2016;Eriksson, von Essen, Jönhagen, & Barenius, 2018;Lee, Lee, Lee, & Hui, 2018;Smith, Postle, Penny, McNamara, & Mann, 2014;Wittenberg, Oxfort, & Plafki, 1998), although early surgical intervention may reduce the risk of subsequent meniscal or chondral injury, both of which are associated with worse outcomes following ACLR (Cinque et al, 2018;Cox et al, 2014).…”

Section: Time To Surgerymentioning

confidence: 99%

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Untitled

2019

NZJP

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Section: Duration and Quantity Of Physiotherapy Treatmentmentioning

confidence: 72%

Section: Time To Surgerymentioning

confidence: 99%

Untitled

2019

NZJP

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“…Firstly, the modest sample size of our study compromises the ability to draw definite conclusions from the results. However, previous systematic reviews on ACL rupture have reported on multiple studies publishing similar sample sizes 2,26,27 . Secondly, the timing of PROMs collection after the decision to undergo ACL reconstruction in our study could influence individual scores.…”

Section: Discussionmentioning

confidence: 99%

Baseline analysis of patients presenting for surgical review of ACL rupture reveals heterogeneity in patient-reported outcome measures

Ting

Scholes²,

Zbrojkiewicz

et al. 2020

Preprint

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Despite establishment of successful surgical techniques and rehabilitation protocols for ACL reconstruction, published return to sport rates are less than satisfactory. This has led orthopaedic surgeons and researchers to develop more robust patient selection methods and investigate prognostic patient characteristics. No previous studies have integrated baseline characteristics and responses to PROMs of patients with ACL rupture presenting for surgical review.Patients electing to undergo ACL reconstruction under the care of a single orthopaedic surgeon at a metropolitan public hospital were enrolled in a clinical quality registry. Patients completed VR-12 PCS and MCS scores, Tegner activity scale and IKDC questionnaires at presentation.Total scores were extracted from the electronic registry, and a machine learning approach (kmeans) was used to identify subgroups based on similarity of questionnaire responses. The average scores in each cluster were compared using ANOVA (Kruskal-Wallis) and nominal 2 logistic regression was performed to determine relationships between cluster membership and patient age, gender, BMI and injury-to-examination delay.A sample of 107 patients with primary ACL rupture were extracted, with 97 (91%) available for analysis with complete datasets. Four clusters were identified with distinct patterns of PROMs responses. These ranged from lowest (Cluster 1) to highest scores for VR-12 and IKDC (Cluster 4). In particular, Cluster 4 returned median scores within 6 points of the PASS for the IKDC score for ACL reconstruction (70.1, IQR 59 -78). Significant (p<0.05) differences in PROMs between clusters was observed using ANOVA, with variance explained ranging from 40-69%.However, cluster membership was not significantly associated with patient age, gender, BMI or injury-to-examination delay.Patients electing to undergo ACL reconstruction do not conform to a homogenous group but represent a spectrum of knee function, general physical and mental health, and preinjury activity levels, which may not lend itself to uniform treatment and rehabilitation protocols. The factors driving these distinct responses to PROMs remain unknown, but are unrelated to common demographic variables.

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“…Although studied extensively in primary ACL reconstruction, the effect of graft type on clinical outcomes has not been evaluated as rigorously in high-quality comparative studies or systematic reviews in the revision setting 37. However, Wright et al have recently compared the outcomes of patients in the Multicentre ACL Revision study (investigating prospectively collected data on 1205 patients from 52 sites) with respect to the graft choice for the procedure.…”

Section: Discussionmentioning

confidence: 99%