SynthesisBMC surgery2025
ACL repair vs. reconstruction: a meta-analysis of outcomes across different tear characteristics.
Synthesis in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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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.
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Who cites it
4 citing papers in PubMed.
- Longitudinal Multiparametric Quantitative MRI Evaluation of Graft Maturity Following Anterior Cruciate Ligament Reconstruction: A One-Year Prospective Observational Study.Diagnostics (Basel, Switzerland) · 2026Article
- Article
- All-Inside and Conventional Techniques in Anterior Cruciate Ligament Reconstruction: A Retrospective Comparison Study.Journal of clinical medicine · 2026Article
- Zlig ligament reconstruction versus tibial plateau leveling osteotomy for cranial cruciate ligament rupture in dogs: a prospective controlled study.Frontiers in veterinary science · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundAnterior cruciate ligament (ACL) reconstruction remains the gold standard but carries donor-site morbidity and prolonged recovery. Modern ACL repair techniques theoretically preserve native proprioception and enable faster rehabilitation. We hypothesized that modern ACL repair would demonstrate non-inferior clinical outcomes compared to reconstruction.This meta-analysis compares clinical outcomes of primary repair versus autograft reconstruction.
methodsWe systematically searched PubMed, Cochrane Library, and Web of Science (2015–2025) for comparative studies (RCTs, cohorts, case-controls) reporting ≥ 2 key outcomes (failure rate, AP knee laxity, IKDC, Lysholm, or Tegner scores) with ≥ 1-year follow-up. Pooled ORs and WMDs with 95% CIs were calculated using RevMan 5.4. Subgroup analyses (injury-to-surgery time, injury location, study design, repair technique) and GRADE assessment were performed.
resultsFourteen studies (4 RCTs, 8 cohorts, 2 case-controls; n = 908 patients) were included (repair: n = 460; reconstruction: n = 448). Failure/Revision Rates: Repair demonstrated numerically higher failure rates (OR = 2.24, 95% CI 1.30–3.86, P = 0.004) and revision rates (OR = 2.01, 95% CI 1.21–3.33, P = 0.007) versus reconstruction.Hardware removal: increased hardware removal incidence was observed in repair groups (OR = 8.19, 95% CI 2.89–23.20, P < 0.001).AP knee laxity: reconstruction showed marginally lower AP knee laxity (WMD = 0.30, 95% CI 0.06–0.53, P = 0.01).Patient-reported outcomes: no significant differences in IKDC (WMD = 1.31,95%CI: −0.01–2.63;P = 0.05) or Tegner scores (WMD: 0.01; 95% CI: -0.28– 0.30;P = 0.94). Lysholm scores slightly favored reconstruction (WMD = 1.62,; 95% CI: 0.35–2.89;P = 0.01).Key subgroup findings: repair achieved comparable outcomes to reconstruction in: (1) RCT-designed studies, (2) Acute repairs (< 21 days post-injury).
conclusionsACL repair is associated with higher failure and revision rates than reconstruction overall, but may be a viable alternative in selected patients with acute proximal tears.
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