Evidence map›Paper›PMID 34929763›Full record

SynthesisCartilage2021

Anterior Cruciate Ligament Reconstruction versus Nonoperative Treatment: Better Function and Less Secondary Meniscectomies But No Difference in Knee Osteoarthritis-A Meta-Analysis.

Marco Cuzzolin, Davide Previtali, Stefano Zaffagnini, Luca Deabate, Christian Candrian, Giuseppe Filardo

Open access · bronzeAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cartilage, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
5.0field-weighted citation impact, top 4% 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

24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.

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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

6 authors at 2 institutions in 2 countries.

Marco CuzzolinOrthopaedic and Traumatology Unit, Ospedale Regionale di Lugano Service of Orthopedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland.ORCID 0000-0002-2653-6677
Davide PrevitaliOrthopaedic and Traumatology Unit, Ospedale Regionale di Lugano Service of Orthopedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland.ORCID 0000-0002-0284-4368
Stefano ZaffagniniClinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Luca DeabateOrthopaedic and Traumatology Unit, Ospedale Regionale di Lugano Service of Orthopedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland.
Christian CandrianOrthopaedic and Traumatology Unit, Ospedale Regionale di Lugano Service of Orthopedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland.
Giuseppe FilardoOrthopaedic and Traumatology Unit, Ospedale Regionale di Lugano Service of Orthopedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland.
Ospedale regionale di Lugano · CHIstituto Ortopedico Rizzoli · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe impact of anterior cruciate ligament (ACL) reconstruction on knee osteoarthritis (OA) is still unclear. The aim of the current meta-analysis was to compare surgical treatment versus nonoperative management of ACL tears to assess the impact of these approaches on knee OA development at a 5 and 10 years of follow-up.

designA meta-analysis was performed after a systematic literature search (May 2021) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Both randomized and nonrandomized comparative studies with more than 5 years of follow-up were selected. Influence of the treatment was assessed in terms of knee OA development, subjective and objective clinical results, activity level, and risk of further surgeries. Risk of bias and quality of evidence were assessed following the Cochrane guidelines.

resultsTwelve studies matched the inclusion criteria, for a total of 1,004 patients. Level of evidence was rated low to very low. No difference was documented in terms of knee OA development, Tegner score, subjective International Knee Documentation Committee (IKDC), and Lysholm scores. A significant difference favoring the surgical treatment in comparison with a nonsurgical approach was observed in terms of objective IKDC score (

conclusionsThe meta-analysis did not support an advantage of ACL reconstruction in terms of OA prevention in comparison with a nonoperative treatment. Moreover, no differences were reported for subjective results and activity level at 5 and 10 years of follow-up. On the contrary, patients who underwent surgical treatment of their ACL tear presented important clinical findings in terms of better objective knee function and a lower rate of secondary meniscectomies when compared with conservatively managed patents.

Indexed as

Anterior Cruciate Ligament ReconstructionConservative TreatmentOsteoarthritis, KneeAdultAgedAged, 80 and overAnterior Cruciate Ligament InjuriesFemaleHumansMaleMeniscectomyMiddle AgedPostoperative Cognitive ComplicationsTreatment OutcomeACL reconstructionanterior cruciate ligamentconservative treatmentosteoarthritisradiologic evaluation

Identifiers

PMID34929763
PMCPMC8808919
OpenAlexW4200193238

What OpenQuestion holds

Textmetadata
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.