Evidence map›Paper›PMID 33687926›Full record

Trial reportBMJ (Clinical research ed.)2021

Early surgical reconstruction versus rehabilitation with elective delayed reconstruction for patients with anterior cruciate ligament rupture: COMPARE randomised controlled trial.

Max Reijman, Vincent Eggerding, Eline van Es, Ewoud van Arkel, Igor van den Brand, Joost van Linge, Jacco Zijl, Erwin Waarsing, Sita Bierma-Zeinstra, Duncan Meuffels

Open access · hybridAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 6 pooled it
19.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 6 syntheses or guidelines pooled it, 138 citations in OpenAlex.

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  4. "Cost-effectiveness of ACL treatment is dependent on age and activity level: a systematic review".Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023
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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Max ReijmanDepartment of Orthopaedics and Sports Medicine, Room NC-424, Erasmus MC University Medical Centre, PO Box 2040, 3000 CA Rotterdam, Netherlands m.reijman@erasmusmc.nl.ORCID 0000-0001-6316-9629
Vincent EggerdingDepartment of Orthopaedics and Sports Medicine, Room NC-424, Erasmus MC University Medical Centre, PO Box 2040, 3000 CA Rotterdam, Netherlands.
Eline van EsDepartment of Orthopaedics and Sports Medicine, Room NC-424, Erasmus MC University Medical Centre, PO Box 2040, 3000 CA Rotterdam, Netherlands.
Ewoud van ArkelDepartment of Orthopaedics, Haaglanden Medical Centre, The Hague, Netherlands.
Igor van den BrandDepartment of Orthopaedics, Elisabeth Tweesteden Hospital, Tilburg, Netherlands.
Joost van LingeDepartment of Orthopaedics, Reinier de Graaf Gasthuis, Delft, Netherlands.
Jacco ZijlDepartment of Orthopaedics, St Antonius Hospital, Nieuwegein, Netherlands.
Erwin WaarsingDepartment of Orthopaedics and Sports Medicine, Room NC-424, Erasmus MC University Medical Centre, PO Box 2040, 3000 CA Rotterdam, Netherlands.
Sita Bierma-ZeinstraDepartment of Orthopaedics and Sports Medicine, Room NC-424, Erasmus MC University Medical Centre, PO Box 2040, 3000 CA Rotterdam, Netherlands.
Duncan MeuffelsDepartment of Orthopaedics and Sports Medicine, Room NC-424, Erasmus MC University Medical Centre, PO Box 2040, 3000 CA Rotterdam, Netherlands.
Erasmus MC · NLElisabeth-TweeSteden Ziekenhuis · NLMedisch Centrum Haaglanden · NLReinier de Graaf Hospital · NLSt. Antonius Ziekenhuis · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess whether a clinically relevant difference exists in patients' perceptions of symptoms, knee function, and ability to participate in sports over a period of two years after rupture of the anterior cruciate ligament (ACL) between two commonly used treatment regimens.

designOpen labelled, multicentre, parallel randomised controlled trial (COMPARE).

settingSix hospitals in the Netherlands, between May 2011 and April 2016.

participantsPatients aged 18 to 65 with an acute rupture of the ACL, recruited from six hospitals. Patients were evaluated at three, six, nine, 12, and 24 months.

interventions85 patients were randomised to early ACL reconstruction and 82 to rehabilitation followed by optional delayed ACL reconstruction after a three month period (primary non-operative treatment). MAIN OUTCOMES: Patients' perceptions of symptoms, knee function, and ability to participate in sporting activities were assessed with the International Knee Documentation Committee score (optimum score 100) at each time point over 24 months.

resultsBetween May 2011 and April 2016, 167 patients were enrolled in the study and randomised to one of two treatments (mean age 31.3; 67 (40.%) women), and 163 (98%) completed the trial. In the rehabilitation and optional delayed ACL reconstruction group, 41 (50%) patients underwent reconstruction during follow-up. After 24 months, the early ACL reconstruction group had a significantly better (P=0.026) but not clinically relevant International Knee Documentation Committee score (84.7

conclusionsIn patients with acute rupture of the ACL, those who underwent early surgical reconstruction, compared with rehabilitation followed by elective surgical reconstruction, had improved perceptions of symptoms, knee function, and ability to participate in sports at the two year follow-up. This finding was significant (P=0.026) but the clinical importance is unclear. Interpretation of the results of the study should consider that 50% of the patients randomised to the rehabilitation group did not need surgical reconstruction.

trial registrationNetherlands Trial Register NL 2618.

Indexed as

AdolescentAdultAgedAnterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionConservative TreatmentElective Surgical ProceduresFemaleFollow-Up StudiesHumansMaleMiddle AgedPatient Reported Outcome MeasuresRecovery of FunctionReturn to SportTime-to-Treatment

Identifiers

PMID33687926
PMCPMC7941216
OpenAlexW3134571115

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.