Annamalai R, Venkatramanaiah C, Sujhithra A, Vignesh N, Danis Vijay D
Research Scholar, Bharath Medical College and Hospital, Bhaarath Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Department of Orthopedics, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Maduranthakam, Tamil Nadu, India.
J Clin Orthop Trauma. 2024 Nov 12;59:102805. doi: 10.1016/j.jcot.2024.102805. eCollection 2024 Dec.
Anterior cruciate ligament (ACL) injury is a significant orthopedic issue globally with varying success rates among different populations. Better understanding of functional outcome can help design suitable protocols for ACL reconstruction and recovery. This review aims to evaluate the epidemiological trends and functional outcomes of ACLR procedures in India.
The review was conducted following PRISMA guidelines, by searching in Google Scholar, Pubmed, Web of Science and Science Direct databases in February 2024. The study encompassed patient demographics, and postoperative outcomes in Indian populations upon ACLR using hamstring tendon autografts. Meta-analysis was conducted with RevMan 5.4 using random-effects models. Funnel plots were used to explore publication bias. Subgroup analyses of follow-up terms and age were also performed.
A total of 26 studies were pooled for overall qualitative and quantitative analysis. Sports injuries (52 %) were found to be more common, followed by road traffic accidents (31 %). Injuries were mostly on the right knees (56 %). Functional outcome analysis using Lysholm Knee Scoring Scale (MD 34.74, 95 % CI 31.58 to 37.89), International Knee Documentation Committee (MD 36.74, 95 % CI 32.36 to 41.13), Tegner Activity Scale (MD 0.90, 95 % CI -0.01 to 1.80) revealed statistically significant overall outcome effect. Statistically non-significant differences were found between follow-up to 6 months and follow-up above 6 months as well as with age. However, meta-analysis showed high level of heterogeneity.
ACLR in Indian population is largely successful in restoring functional activity. However, the outcome of this review is limited by the heterogeneity factor. Further, the Indian studies have not focused on factors affecting the outcome. Therefore, future studies in this direction are needed for understanding the clinical success.
前交叉韧带（ACL）损伤是一个全球性的重要骨科问题，不同人群的成功率各不相同。更好地了解功能结果有助于设计适合ACL重建和恢复的方案。本综述旨在评估印度ACL重建手术（ACLR）的流行病学趋势和功能结果。
本综述按照PRISMA指南进行，于2024年2月在谷歌学术、PubMed、科学网和科学直投数据库中进行检索。该研究涵盖了印度人群接受自体腘绳肌腱ACLR后的患者人口统计学和术后结果。使用RevMan 5.4采用随机效应模型进行荟萃分析。使用漏斗图探索发表偏倚。还对随访时间和年龄进行了亚组分析。
共纳入26项研究进行总体定性和定量分析。发现运动损伤（52%）更为常见，其次是道路交通事故（31%）。损伤大多发生在右膝（56%）。使用Lysholm膝关节评分量表（MD 34.74，95%CI 31.58至37.89）、国际膝关节文献委员会（MD 36.74，95%CI 32.36至41.13）、Tegner活动量表（MD 0.90，95%CI -0.01至1.80）进行的功能结果分析显示总体结果效应具有统计学意义。在6个月随访和6个月以上随访以及年龄之间未发现统计学上的显著差异。然而，荟萃分析显示异质性水平较高。
印度人群的ACLR在恢复功能活动方面大多是成功的。然而，本综述的结果受到异质性因素的限制。此外，印度的研究尚未关注影响结果的因素。因此，需要在这个方向上进行进一步的研究以了解临床成功率。
