Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Nov 19:64:130-138.
doi: 10.1016/j.jor.2024.11.013. eCollection 2025 Jun.

Repair with suture tape augmentation vs. reconstruction for ACL tears: A systematic review and meta-analysis

Rodrigo Arruda Conde  1 , André Richard da Silva Oliveira Filho  2 , Elcio Machinski  3 , Vinícius Furtado da Cruz  4 , Bruno Butturi Varone  5 , Riccardo Gomes Gobbi  5 , Camilo Partezani Helito  5 , Daniel Peixoto Leal  5
Affiliations
Review

Repair with suture tape augmentation vs. reconstruction for ACL tears: A systematic review and meta-analysis

Rodrigo Arruda Conde et al. J Orthop. .

Abstract

Background and aims: Interest in repairing ruptured anterior cruciate ligaments (ACL) has resurged, with suture tape augmentation (internal brace, ACL-IB) emerging as a prominent technique. However, the efficacy of ACL-IB compared to ACL reconstruction (ACL-R) remains unclear. We conducted a meta-analysis to address this gap.

Methods: Adhering to PRISMA guidelines, a search to PubMed, EMBASE and Cochrane Central for studies comparing ACL-IB to ACL-R was performed. The main endpoints were patient-reported outcomes (PROs) and failure rate. Muscle and joint function and surgery time were also assessed. Statistical analysis was performed by Review Manager 5.1.7.

Results: Nine studies comprising 1049 patients were included; 381 (36.3 %) underwent ACL-IB. Hamstring autografts were used for ACL-R in 421 patients (63.0 %). Most studies (6 of 8) reported follow-up longer than two years. The failure rate was higher in the ACL-IB group (risk ratio 3.62; 95 % CI 1.16 to 11.33; p = 0.03; I2: 52 %). No significant difference was found between groups for PROs, except KOOS Symptoms, which was significantly improved with ACL-IB (mean difference 2.49; 95 % CI 0.05 to 4.92; p = 0.05; I2: 0 %). ACL-IB resulted in stronger hamstrings (mean difference 11.99 %; 95 % CI 4.47 %-19.51 %; p = 0.002; I2: 73 %). No significant difference was found in anterior tibial translation and quadriceps strength.

Conclusions: ACL-IB had a higher failure rate compared to ACL-R. However, ACL-IB showed better hamstring strength and KOOS symptom score. No significant differences were seen in other PROs, time to return to sports, or quadriceps strength.

Keywords: Anterior cruciate ligament; Failure rate; Internal brace; Reconstruction; Repair; Suture tape augmentation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Similar articles

See all similar articles

References

    1. Markolf K.L., Mensch J.S., Amstutz H.C. Stiffness and laxity of the knee--the contributions of the supporting structures. A quantitative in vitro study. JBJS. 1976;58(5):583–594. - PubMed
    1. Lyman S., Koulouvaris P., Sherman S., Do H., Mandl L.A., Marx R.G. Epidemiology of anterior cruciate ligament reconstruction: trends, readmissions, and subsequent knee surgery. JBJS. 2009;91(10):2321–2328. doi: 10.2106/JBJS.H.00539. - DOI - PubMed
    1. England R.L. Repair of the ligaments about the knee. Orthop Clin N Am. 1976;7(1):195–204. - PubMed
    1. Robson A.W.M. VI. Ruptured crucial ligaments and their repair by operation. Ann Surg. 1903;37(5):716. - PMC - PubMed
    1. Marshall J.L., Warren R.F., Wickiewicz T.L., Reider B. The anterior cruciate ligament: a technique of repair and reconstruction. Clin Orthop Relat Res. 1979;143:97–106. - PubMed

LinkOut - more resources