Evidence map›Paper›PMID 39976186›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025

The recovery trajectory of anterior cruciate ligament ruptures in randomised controlled trials: A systematic review and meta-analysis of operative and nonoperative treatments.

Ali Ridha, Siddarth Raj, Henry Searle, Imran Ahmed, Nicholas Smith, Andrew Metcalfe, Chetan Khatri

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
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

7 authors.

Ali RidhaTrauma and Orthopaedics, University of Warwick, Coventry, United Kingdom of Great Britain and Northern Ireland.ORCID http://orcid.org/0000-0001-7652-989X
Siddarth RajTrauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom of Great Britain and Northern Ireland.
Henry SearleTrauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave General Hospital, Coventry, United Kingdom of Great Britain and Northern Ireland.
Imran AhmedTrauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave General Hospital, Coventry, United Kingdom of Great Britain and Northern Ireland.
Nicholas SmithTrauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, UHCW, Coventry, United Kingdom of Great Britain and Northern Ireland.
Andrew MetcalfeTrauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave General Hospital, University of Warwick, Coventry, United Kingdom of Great Britain and Northern Ireland.
Chetan KhatriTrauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave General Hospital, University of Warwick, Coventry, United Kingdom of Great Britain and Northern Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this research was to understand the trajectory of recovery following anterior cruciate ligament (ACL) reconstruction compared to nonoperative treatments.

methodsA systematic review and meta-analysis approach was used to evaluate randomised controlled trials (RCTs). A comprehensive search was conducted on databases including Medline, Embase, Web of Science and The Cochrane Central Register of Controlled Trials up until 18 May 2023. The study focused on full-text RCTs involving patients with partial or complete ACL tears. Included were studies focusing on patients undergoing ACL reconstruction or nonoperative care. The primary outcome was characterising the effects of treatments and tracking changes in International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) outcomes over time. The secondary outcome was characterising and tracking the changes of the knee injury and osteoarthritis outcome score subscales, ACL-quality-of-life questionnaire, Lysholm, Tegner and CKRS scores.

resultsA total of 84 RCTs were included. The pooled standardised mean changes for the IKDC compared with baseline were: 2.0 (95% confidence interval [CI]: 0.3-3.6) at 3 months, 2.2 (95% CI: 0.9-3.6) at 6 months, 2.2 (95% CI: 0.8-3.6) at 12 months and 2.3 (95% CI: 1.3-3.4) at 24 months. Graphs illustrating IKDC scores over time further emphasise these findings, showing a sustained improvement over time to 12 months, with a plateauing of scores past this time point. Our secondary outcome patient-reported outcome measures (PROMs) also showed a similar pattern with scores plateauing at the 12-months mark.

conclusionOur findings suggest that the IKDC score and other PROMs are effective for tracking recovery up to 12 months. Other PROMs show pain and daily activities generally recover within 6 months, and quality of life improves up to 12 months, but PROMs show minimal improvement beyond this period. This inconsistency with a return sport period indicates that PROMs may lack the sensitivity required to assess this aspect of recovery accurately. LEVEL OF EVIDENCE: Level I.

Indexed as

Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionHumansQuality of LifeRandomized Controlled Trials as TopicRecovery of FunctionACLkneePROMsreconstructionrehabilitation

Identifiers

PMID39976186
PMCPMC12582240

What OpenQuestion holds

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Registered trials

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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.