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Review
. 2022 Dec 12:36:11-17.
doi: 10.1016/j.jor.2022.11.018. eCollection 2023 Feb.

Is augmentation the best solution in partial anterior cruciate ligament tears? A literature systematic review and meta-analysis

Francesco Bosco  1 , Fortunato Giustra  1 , Michele Crivellaro  1 , Riccardo Giai Via  1 , Alessandro Dario Lavia  2 , Marcello Capella  1 , Luigi Sabatini  1 , Salvatore Risitano  1 , Giuseppe Rovere  3 , Alessandro Massè  1 , Raju Vaishya  4
Affiliations
Review

Is augmentation the best solution in partial anterior cruciate ligament tears? A literature systematic review and meta-analysis

Francesco Bosco et al. J Orthop. .

Abstract

Purpose: The appropriate management of partial anterior cruciate ligament (ACL) tears is still debated. There is a tendency in orthopedic clinical practice to prefer complete ACL reconstruction, while few surgeons perform ACL augmentation. The purpose of the present study is to evaluate the current evidence on the effectiveness of ACL augmentation compared with standard ACL reconstruction to assess whether ACL augmentation may be the treatment of choice in partial ACL injury.

Methods: According to PRISMA guidelines, literature research was performed in PubMed/Medline, Cochrane Library, Embase, Scopus, and Web of Science databases. A PICOS model was used, and a preliminary search resulted in 1101 articles. The methodological quality was assessed through ROBINS-I. A meta-analysis was conducted on postoperative Tegner, Lysholm scores and KT-1000 values between ACL augmentation and ACL reconstruction, and a p < 0.05 has been assumed as statistically significant. PROSPERO, ID: CRD42022343502.

Results: Seven papers were included. A total of 472 knees underwent ACL reconstruction, and 311 underwent ACL augmentation. A statistically significant discrepancy was found in the postoperative Tegner score in favor of ACL augmentation compared with ACL reconstruction (p < 0.05). Regarding the postoperative Lysholm score and KT-1000 measurement, no statistically significant difference was shown between ACL reconstruction and ACL augmentation (p > 0.05).

Conclusions: ACL augmentation has proved to be an effective and safe procedure and should be preferred to ACL reconstruction in partial ACL tears for the tendency to achieve better functional outcomes.

Keywords: ACL augmentation; ACL reconstruction; Arthroscopy; Knee; Partial ACL tear.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1
PRISMA flowchart.
Fig. 2
Fig. 2
ROBINS-I tool assessment.
Fig. 3
Fig. 3
Postoperative Tegner score values regarding ACLR and ACL AUG in a partial ACL tear. Funnel plot.
Fig. 4
Fig. 4
Postoperative Lysholm score values regarding ACLR and ACL AUG in a partial ACL tear. Funnel plot.
Fig. 5
Fig. 5
KT-1000 arthrometer evaluation regarding ACLR and ACL AUG in a partial ACL tear. Funnel plot.
See this image and copyright information in PMC

References

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