Comparison of arthroscopic primary repair versus reconstruction for proximal anterior cruciate ligament tears: a meta-analysis
10.3760/cma.j.cn115530-20240619-00260
- VernacularTitle:关节镜下初次修复术与重建术治疗前交叉韧带近端损伤的Meta分析
- Author:
Jianhao FENG
1
;
Yihong XU
;
Weidong XU
Author Information
1. 同济大学附属同济医院骨科，上海 200065
- Keywords:
Knee joint;
Anterior cruciate ligament;
Arthroscopy;
Repair;
Reconstruction;
Meta-analysis
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(7):626-631
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the arthroscopic primary repair versus reconstruction for proximal anterior cruciate ligament (ACL) tears by a meta analysis.Methods:A comprehensive computer search was performed in China National Knowledge Infrastructure, WanFang Data, Pubmed, Web of Since, The Cochrane Library for studies comparing primary ACL repair and ACL reconstruction published before August, 2023. A meta-analysis was performed using RevMan 5.4 software to compare the surgical failure rate in repair of proximal ACL tears, International Knee Documentation Committee (IKDC) score, Lysholm score, patient satisfaction score of visual analogue scale (VAS), positive rate of Lachman test, and side-to-side difference in anterior tibial translation.Results:Included in this meta analysis were 8 articles (4 randomized controlled trials and 4 cohort studies) involving 217 eligible patients undergoing primary ACL repair and 187 eligible patients undergoing ACL reconstruction. The follow-up duration for the cases in the literature ranged from 12 to 28 months. The meta analysis showed that the short-term side-to-side difference in anterior tibial translation in the primary ACL repair group was significantly larger than that in the ACL reconstruction group ( MD=0.75, 95% CI: 0.33 to 1.16, P<0.001). However, there were no significant differences between the 2 groups in IKDC score, Lysholm score, positive rate in the Lachman test, VAS patient satisfaction score, or surgical failure rate ( P>0.05). Conclusions:Compared with ACL reconstruction, arthroscopic primary ACL repair may lead to similar functional recovery and clinical outcomes in the early postoperative period (12 to 28 months). However, caution should be exercised against primary ACL repair because it is related to greater asymptomatic knee laxity.
