Abstract：
OBJECTIVE: This study aims to determine the efficacy of anterior cruciate ligament reconstruction (ACLR) using autograft combined with or without ligament augmentation.
METHODS: A computerized search of the databases was conducted, including PubMed, Web of Science, Embase, Scopus and the Cochrane Library. Only prospective or retrospective comparative studies with a minimum 2-year follow-up were considered for inclusion. Two independent reviewers performed data extraction and methodological quality assessment. A Mantel-Haenszel analysis was used for the pooling of results. Sensitivity analysis was performed to maintain the stability of results. The egger test was applied to assess the publication bias.
RESULTS: Fourteen studies were included. The total cohort was 1353 patients (non-augmented group: 763 patients; augmented group: 590 patients). There were three Randomized Controlled Trials (RCTs, Level I), six retrospective comparative studies (Level III) and five case-control studies (Level III). The follow-up rate was ≥ 88% and the follow-up periods were ≥ 24 months in all included studies. The augmented graft used to compare with autograft included the Ligament Augmentation Device (LAD), the Ligament Advanced Reinforcement System (LARS) artificial ligament, FiberTape, hamstring tendon allograft, degradable poly (urethane urea). No significant differences were observed between the augmented and non-augmented groups regarding postoperative patient-reported outcomes (PROs), including the International Knee Documentation Committee score, Lysholm score and Tegner score, knee laxity, including KT-1000, side-to-side difference, Lachman test and pivot shift and rate of graft failure.
CONCLUSIONS: ACLR using autografts combined with ligament augmentation shows no advantages in PROs, knee laxity and graft failure rate compared with using autografts only.
METHODS: Level III.
BACKGROUND: The research protocol was registered at the PROSPERO database (CRD42022324784).
METHODS: A computerized search of the databases was conducted, including PubMed, Web of Science, Embase, Scopus and the Cochrane Library. Only prospective or retrospective comparative studies with a minimum 2-year follow-up were considered for inclusion. Two independent reviewers performed data extraction and methodological quality assessment. A Mantel-Haenszel analysis was used for the pooling of results. Sensitivity analysis was performed to maintain the stability of results. The egger test was applied to assess the publication bias.
RESULTS: Fourteen studies were included. The total cohort was 1353 patients (non-augmented group: 763 patients; augmented group: 590 patients). There were three Randomized Controlled Trials (RCTs, Level I), six retrospective comparative studies (Level III) and five case-control studies (Level III). The follow-up rate was ≥ 88% and the follow-up periods were ≥ 24 months in all included studies. The augmented graft used to compare with autograft included the Ligament Augmentation Device (LAD), the Ligament Advanced Reinforcement System (LARS) artificial ligament, FiberTape, hamstring tendon allograft, degradable poly (urethane urea). No significant differences were observed between the augmented and non-augmented groups regarding postoperative patient-reported outcomes (PROs), including the International Knee Documentation Committee score, Lysholm score and Tegner score, knee laxity, including KT-1000, side-to-side difference, Lachman test and pivot shift and rate of graft failure.
CONCLUSIONS: ACLR using autografts combined with ligament augmentation shows no advantages in PROs, knee laxity and graft failure rate compared with using autografts only.
METHODS: Level III.
BACKGROUND: The research protocol was registered at the PROSPERO database (CRD42022324784).
摘要：
目的：本研究旨在确定使用自体移植结合或不结合韧带增强的前交叉韧带重建（ACLR）的功效。
方法：对数据库进行了计算机搜索，包括PubMed,WebofScience,Embase,Scopus和Cochrane图书馆。仅考虑纳入至少2年随访的前瞻性或回顾性比较研究。两名独立的审查员进行了数据提取和方法学质量评估。Mantel-Haenszel分析用于汇集结果。进行灵敏度分析以保持结果的稳定性。采用egger检验评估发表偏倚。
结果：纳入14项研究。总队列为1353名患者（非增强组：763名患者；增强组：590名患者）。有三项随机对照试验(随机对照试验，一级),6项回顾性比较研究(III级)和5项病例对照研究(III级).所有纳入研究的随访率≥88%，随访时间≥24个月。用于与自体移植物比较的增强移植物包括韧带增强装置（LAD），韧带高级加固系统（LARS）人工韧带，FiberTape,绳肌腱同种异体移植,可降解聚氨酯脲。在术后患者报告结果（PRO）方面，增强组和非增强组之间没有观察到显着差异。包括国际膝盖文献委员会的分数，Lysholm得分和Tegner得分,膝盖松弛，包括KT-1000，侧面差异，Lachman试验和枢轴移位和移植物失败率。
结论：使用自体移植物联合韧带增强的ACLR在PRO中没有优势，与仅使用自体移植物相比，膝关节松弛和移植物失败率。
方法：三级。
背景：研究方案已在PROSPERO数据库（CRD42022324784）中注册。
方法：对数据库进行了计算机搜索，包括PubMed,WebofScience,Embase,Scopus和Cochrane图书馆。仅考虑纳入至少2年随访的前瞻性或回顾性比较研究。两名独立的审查员进行了数据提取和方法学质量评估。Mantel-Haenszel分析用于汇集结果。进行灵敏度分析以保持结果的稳定性。采用egger检验评估发表偏倚。
结果：纳入14项研究。总队列为1353名患者（非增强组：763名患者；增强组：590名患者）。有三项随机对照试验(随机对照试验，一级),6项回顾性比较研究(III级)和5项病例对照研究(III级).所有纳入研究的随访率≥88%，随访时间≥24个月。用于与自体移植物比较的增强移植物包括韧带增强装置（LAD），韧带高级加固系统（LARS）人工韧带，FiberTape,绳肌腱同种异体移植,可降解聚氨酯脲。在术后患者报告结果（PRO）方面，增强组和非增强组之间没有观察到显着差异。包括国际膝盖文献委员会的分数，Lysholm得分和Tegner得分,膝盖松弛，包括KT-1000，侧面差异，Lachman试验和枢轴移位和移植物失败率。
结论：使用自体移植物联合韧带增强的ACLR在PRO中没有优势，与仅使用自体移植物相比，膝关节松弛和移植物失败率。
方法：三级。
背景：研究方案已在PROSPERO数据库（CRD42022324784）中注册。
