Zhang Ting, Ye Xiaojin, Huang Qing, Zhou Ke, Li Jin, Gan Kaifeng
Department of Orthopedics The Affiliated LiHuiLi Hospital of Ningbo University Ningbo Zhejiang China.
Department of Orthopedics, The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China.
J Exp Orthop. 2025 Apr 13;12(2):e70235. doi: 10.1002/jeo2.70235. eCollection 2025 Apr.
To perform a meta-analysis to compare the clinical outcomes and failure rate of anterior cruciate ligament (ACL) repair and ACL reconstruction in acute ACL rupture.
Studies were searched on PubMed, Web of Science, and EMBASE for randomized controlled trials comparing ACL repair versus ACL reconstruction for ACL rupture. The bias risk was based on the Cochrane Handbook for Systematic Reviews of Interventions. Clinical outcomes included IKDC score, Lysholm score, Tegner score, anteroposterior (AP) knee laxity, and failure rate. The funnel plots were used to detect publication bias.
Six randomized controlled study (RCTs) were included in this meta-analysis, involving a total of 478 patients. The mean follow-up varied from 1 to 5 years. The mean age of patients was between 17 and 29.1 years, the mean time from injury to surgery was 13-39 days. We found no statistical differences between ACL repair and ACLR in IKDC score (0.11; 95% CI, -0.17 to 0.40; = 0.440; = 56.8%), Lysholm score (0.16; 95% CI, -0.10 to 0.42; = 0.214; = 28.8%), Tegner score (0.05; 95% CI, -0.23 to 0.34; = 0.719; = 0.0%), AP knee laxity (0.05; 95% CI, -0.17 to 0.27; = 0.636; = 0.0%), and failure rate (RR, 1.10; 95% CI, 0.70-1.72; = 0.695; = 27.3%).
ACL repair showed similar clinical outcomes compared with ACLR, and it could replace ACLR as an appropriate surgical method for acute proximal ACL rupture, but the indication and selection of patients are essential to be considered. Large numbers and more high-quality studies are still needed in the future to verify our results.
Level I.
进行一项荟萃分析，比较急性前交叉韧带（ACL）断裂时ACL修复与ACL重建的临床疗效和失败率。
在PubMed、科学网和EMBASE上检索比较ACL断裂时ACL修复与ACL重建的随机对照试验。偏倚风险基于《Cochrane干预措施系统评价手册》。临床疗效包括国际膝关节文献委员会（IKDC）评分、Lysholm评分、Tegner评分、膝关节前后（AP）松弛度和失败率。采用漏斗图检测发表偏倚。
本荟萃分析纳入了6项随机对照研究（RCT），共涉及478例患者。平均随访时间为1至5年。患者的平均年龄在17至29.1岁之间，受伤至手术的平均时间为13 - 39天。我们发现ACL修复与ACL重建在IKDC评分（0.11；95%CI，-0.17至0.40；P = 0.440；I² = 56.8%）、Lysholm评分（0.16；95%CI，-0.10至0.42；P = 0.214；I² = 28.8%）、Tegner评分（0.05；95%CI，-0.23至0.34；P = 0.719；I² = 0.0%）、膝关节AP松弛度（0.05；95%CI，-0.17至0.27；P = 0.636；I² = 0.0%）和失败率（RR，1.10；95%CI，0.70 - 1.72；P = 0.695；I² = 27.3%）方面无统计学差异。
与ACL重建相比，ACL修复显示出相似的临床疗效，它可以作为急性近端ACL断裂的一种合适手术方法替代ACL重建，但患者的适应证和选择至关重要。未来仍需要大量更多高质量的研究来验证我们的结果。
I级
