Reduced knee laxity and failure rate following anterior cruciate ligament reconstruction compared with repair for acute tears: a meta-analysis

Abstract

Background Following anterior cruciate ligament (ACL) tears, both repair and reconstruction may be performed to restore joint biomechanics and proprioception. The present study compared joint laxity, patient-reported outcome measures (PROMs), and rate of failure following primary repair versus reconstruction for ACL ruptures. Methods This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pubmed, Google scholar, Embase, and Web of Science were accessed in September 2022. All the clinical investigations comparing repair versus reconstruction for primary ACL tears were accessed. Studies reporting data on multiple ligament injuries settings were not eligible. Results Data from eight articles (708 procedures) were collected. The mean length of the follow-up was 67.3 ± 119.4 months. The mean age of the patients was 27.1 ± 5.7 years. Thirty-six percent (255 of 708 patients) were women. The mean body mass index (BMI) was 24.3 ± 1.1 kg/m2. The mean time span from injury to surgery was 36.2 ± 32.3 months. There was comparability at baseline with regards to instrumental laxity, Lachman test, International Knee Document Committee (IKDC), and Tegner Scale (P > 0.1). Similarity between ACL reconstruction and repair was found in IKDC (P = 0.2) and visual analog scale (VAS) satisfaction (P = 0.7). The repair group demonstrated greater mean laxity (P = 0.0005) and greater rate of failure (P = 0.004). Conclusion ACL reconstruction may yield greater joint stability and lower rate of failure compared with surgical repair. Similarity was found in PROMs. Level of evidence: III

Anterior cruciate ligament reconstruction in skeletally immature patients is effective: A systematic review

“…Traditionally, ACL tears in skeletally immature patients were treated conservatively with bracing and physiotherapy, as ACL reconstruction techniques could damage the growing epiphyseal plates, potentially leading to growth disturbances, including leg-length discrepancy or angular deformities [5,6]. However, instability sensation might persist and soft tissue injuries might occur following conservative management [7,8]. Different surgical techniques for ACL reconstruction to avoid epiphyseal plate injuries have been described [9,10].…”

Combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction

“…Anterior cruciate ligament (ACL) reconstruction improves knee laxity [20,22]; however, previous studies have reported that quadriceps muscles were still weak after surgery [5, Extended author information available on the last page of the article 18]. Quadriceps strength recovery after ACL reconstruction was associated with postoperative hop performance [4,6,34], self-reported knee function [6,14,36], patellar cartilage injury [10,31], and return to preinjury sports [1,17,21].…”

Return to Soccer After Acute Anterior Cruciate Ligament Primary Repair: A 2-Year Minimum Follow-up Study of 50 Amateur Players

“…11,15 In addition, ACL repair preserves the proprioceptive function of the native ligament and the range of motion (ROM) of the knee and prevents donor site morbidity. 16,22,28 Although limited research on RTS after ACL primary repair is available, a recent study including 60 patients with a minimum 2-year follow-up demonstrated a 60% rate of return to preinjury activity levels. 26 However, to the best of our knowledge, specific research focusing on return to soccer after ACL repair is lacking.…”