AUTHOR=Pang Long , Li Pengcheng , Li Tao , Li Yinghao , Zhu Jing , Tang Xin 

TITLE=Arthroscopic Anterior Cruciate Ligament Repair Versus Autograft Anterior Cruciate Ligament Reconstruction: A Meta-Analysis of Comparative Studies

JOURNAL=Frontiers in Surgery

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.887522

DOI=10.3389/fsurg.2022.887522

ISSN=2296-875X

ABSTRACT=<sec><title>Purpose</title><p>To compare the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) repair and autograft ACL reconstruction for ACL ruptures.</p></sec><sec><title>Methods</title><p>PubMed, EMBASE, Scopus, Web of Science and The Cochrane Library were searched for relevant studies from 1 January 1990 to 21 March 2022. Two evaluators independently screened the literature, extracted data and assessed the methodological quality of the enrolled studies. Meta-analysis was conducted using RevMan 5.4 software.</p></sec><sec><title>Results</title><p>Ten studies with mean follow-up periods from 12 to 36 months were included. For 638 patients with ACL ruptures, arthroscopic ACL repair showed statistically comparable outcomes of failure (<italic>p</italic> = 0.18), complications (<italic>p</italic> = 0.29), reoperation other than revision (<italic>p</italic> = 0.78), Lysholm score (<italic>p</italic> = 0.78), Tegner score (<italic>p</italic> = 0.70), and satisfaction (<italic>p</italic> = 0.45) when compared with autograft ACL reconstruction. A significantly higher rate of hardware removal (<italic>p</italic> = 0.0008) but greater International Knee Documentation Committee (IKDC) score (<italic>p</italic> = 0.009) were found in the ACL repair group. The heterogeneity of the side-to-side difference of anterior tibial translation (ΔATT) was high (<italic>I</italic><sup>2 </sup>= 80%). After the sensitivity analysis, the <italic>I</italic><sup>2</sup> decreased dramatically (<italic>I</italic><sup>2 </sup>= 32%), and the knees with ACL repair showed significantly greater ΔATT (<italic>P</italic> = 0.04).</p></sec><sec><title>Conclusion</title><p>For proximal ACL ruptures, arthroscopic ACL repair showed similar clinical outcomes, and even better functional performance when compared to autograft ACL reconstruction. ACL repair has a higher rate of hardware removal, and might be related to greater asymptomatic knee laxity. More high-quality prospective trials are needed to confirm our findings.</p></sec>