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Comparison of Clinical Outcomes Between Modern Augmented ACL Repair and Autograft ACL Reconstruction: A Systematic Review and Meta-analysis of Studies With Minimum 2-Year Follow-up.
Ren, Yunong; Wang, Jia; Ji, Junjie; Zhang, Chao; Meng, Qingyang.
Afiliação
  • Ren Y; Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China.
  • Wang J; Medical College of Qingdao University, Qingdao, Shandong, China.
  • Ji J; Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
  • Zhang C; Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
  • Meng Q; Medical College of Qingdao University, Qingdao, Shandong, China.
Orthop J Sports Med ; 12(1): 23259671231223743, 2024 Jan.
Article em En | MEDLINE | ID: mdl-38282789
ABSTRACT

Background:

Anterior cruciate ligament (ACL) reconstruction has been the gold standard for primary ACL rupture since the 1990s. In the past decade, ACL repair has received renewed attention and increased research.

Purpose:

To compare the clinical outcomes of modern augmented ACL repair versus autograft reconstruction for ACL ruptures. Study

Design:

Systematic review; Level of evidence, 3.

Methods:

A search of the PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library databases was conducted for prospective or retrospective comparative studies published between January 1, 2010, and January 3, 2023, with a minimum 2-year follow-up. Two independent reviewers performed data extraction and methodological quality assessment. Sensitivity analysis was performed to maintain the stability of results.

Results:

Nine studies were included (minimum follow-up period, 24-60 months). The total sample size was 833 patients (augmented repair group 358 patients; autograft ACL reconstruction group 475 patients). There were 4 randomized controlled trials (level 1), 1 prospective comparative study (level 2), 2 retrospective comparative studies (level 3), and 2 case-control studies (level 3). The augmented ACL repair group attained significantly higher Lysholm score (weighted mean difference [WMD] = 1.57; 95% confidence interval [CI], 0.14-3.01; P = .03) and hamstring strength (WMD = 36.69; 95% CI, 29.07-44.31; P < .01) but had higher rates of hardware removal (odds ratio [OR] = 6.30; 95% CI, 2.44-16.23; P = .0001), reoperation (OR = 1.87; 95% CI, 1.33-2.62; P = .0003), and failure (OR = 1.58; 95% CI, 1.03-2.43; P = .0003) compared with the autograft ACL reconstruction group. No significant differences were observed between the repair and reconstruction groups regarding postoperative International Knee Documentation Committee scores, Tegner scores, knee laxity, satisfaction, ACL revisions, complications, and reoperation rather than revision.

Conclusion:

Augmented ACL repair was associated with higher rates of reoperation, hardware removal, and failure compared with autograft ACL reconstruction in studies with minimum 2-year follow-up data. However, augmented ACL repair had higher Lysholm scores and hamstring strength versus autograft ACL reconstruction.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article