Vasudeva Nagashree, Elangovan Ajay Gowtham Amutham, Ramakanth Rajagopalakrishnan, Singhi Prahalad Kumar, D'Ambrosi Riccardo, Kambhampati Srinivas B S
Mahaveer Medical Centre, Mangalore, India.
Gowtham Multispecialty Hospital Pvt Ltd, Coimbatore, India.
Indian J Orthop. 2024 Dec 31;59(4):472-487. doi: 10.1007/s43465-024-01321-1. eCollection 2025 Apr.
Multiligament knee injuries are an uncommon and heterogeneous group of injuries and standardizing reporting on these injuries is a challenge. Given the complexity of multiligament knee injuries (MLKIs) and the ongoing debate regarding optimal management strategies, a comprehensive understanding of the current evidence is essential to guide evidence-based decision-making and improve patient care.
In this systematic review, we aimed to assess the systematic reviews and meta-analyses on MLKIs and synthesize their findings. This will enable us to identify areas where the current evidence is strong and where further research is needed.
Adhering to PRISMA guidelines, a comprehensive search in PubMed, Embase, and Cochrane Library identified 36 eligible systematic reviews. AMSTAR 2 criteria were used to assess the methodological quality. For agreement between the raters, the inter-rater reliability Cohen's kappa was used.
Most of the systematic reviews assessed with AMSTAR 2 criteria had a critically low level of evidence ( = 26), with the rest being low ( = 8), moderate ( = 3), and one high, indicating caution in interpreting findings.
This study highlights the scarcity of high-quality systematic reviews (SRs) on multiligament knee injuries (MLKIs), largely due to the diversity in injury patterns, management protocols, and reporting standards.
Most research on these injuries are of low quality, and recommendations have been made to improve reporting. Many areas of these injuries require further studies to improve the outcomes.
膝关节多韧带损伤是一组罕见且异质性的损伤，对这些损伤进行标准化报告具有挑战性。鉴于膝关节多韧带损伤（MLKIs）的复杂性以及关于最佳治疗策略的持续争论，全面了解当前证据对于指导循证决策和改善患者护理至关重要。
在本系统评价中，我们旨在评估关于MLKIs的系统评价和荟萃分析，并综合其结果。这将使我们能够确定当前证据充分的领域以及需要进一步研究的领域。
遵循PRISMA指南，在PubMed、Embase和Cochrane图书馆进行全面检索，确定了36项符合条件的系统评价。使用AMSTAR 2标准评估方法学质量。对于评估者之间的一致性，采用评估者间信度Cohen's kappa。
根据AMSTAR 2标准评估的大多数系统评价证据水平极低（=26），其余为低（=8）、中等（=3）和一项高，这表明在解释结果时需谨慎。
本研究强调了关于膝关节多韧带损伤（MLKIs）的高质量系统评价（SRs）的稀缺性，这主要归因于损伤模式、治疗方案和报告标准的多样性。
关于这些损伤的大多数研究质量较低，并已提出改进报告的建议。这些损伤的许多领域需要进一步研究以改善治疗结果。
