PubMed, Embase, and Cochrane Library were searched by two researchers for clinical studies comparing ACLR with and without LET. Studies with only evidence levels I and II and studies in which anterior lateral ligament reconstruction was performed with grafts were excluded. The risk of bias of the studies was assessed using the Cochrane risk-of-bias and modified Downs & Black tools. The outcomes included (1) functional outcomes; (2) knee laxity measures; (3) knee injury osteoarthritis and outcome score; and (4) complications. The outcomes of the two groups were extracted, summarized and compared.
A total of 234 studies were retrieved and 223 were excluded. Eleven clinical studies with 1745 patients were included in our meta-analysis. Compared to the patients who underwent ACLR alone, the patients who underwent ACLR with LET had reduced pivot-shift (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.31 to 0.74, p = 0.0009), and lower graft failure rate (OR 0.34, 95% CI 0.20 to 0.55, p < 0.0001).
Compared with ACLR only, ACLR combined with LET can effectively reduce rotation laxity of the knee joint, and reduce the graft failure rate in high-risk patients. However, the effects on the function and activity level of patients cannot be confirmed.
PubMed,Embase,和Cochrane图书馆由两名研究人员搜索,以进行比较有和没有LET的ACLR的临床研究。排除仅具有I级和II级证据的研究以及使用移植物进行前外侧韧带重建的研究。使用Cochrane偏差风险和改良的Downs&Black工具评估了研究的偏差风险。结果包括(1)功能结果;(2)膝关节松弛度测量;(3)膝关节损伤骨关节炎和结果评分;(4)并发症。提取两组的结果,总结和比较。
共检索了234项研究,排除了223项。我们的荟萃分析包括了11项涉及1745例患者的临床研究。与单独接受ACLR的患者相比,接受LET的ACLR患者的枢轴移位减少(比值比[OR]0.48,95%置信区间[CI]0.31至0.74,p=0.0009),移植物失败率较低(OR0.34,95%CI0.20至0.55,p<0.0001)。
与仅ACLR相比,ACLR联合LET能有效减少膝关节的旋转松弛,并降低高危患者的移植物失败率。然而,对患者功能和活动水平的影响无法证实。