ReviewOpen access journal of sports medicine2025
Deciding Between ACL Reconstruction, Repair, and Conservative Treatment in Young Athletes: A Systematic Narrative Review.
Review in Open access journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: The best pediatric and adolescent athlete anterior cruciate ligament (ACL) injury management method remains unknown. This systematic narrative review examined ACL reconstruction (ACLR), ACL repair, and conservative brace, or rehabilitation-based therapeutic exercise interventions with a delayed ACLR option for pediatric and adolescent ACL injury management. The primary purpose was to compare failure rates, return to sport (RTS) rates, and perceived knee function. Methods: The PubMed, ResearchGate, Google Scholar, Sage Journals, and OVID (Medline) databases were searched. The Modified Coleman Methodology Score (MCMS) assessed study methodological quality and bias risk. Results: Fifty-six studies were included. Group 1 (ACLR) studies were published before Group 2 (ACL repair) or Group 3 (conservative brace, or rehabilitation-based therapeutic exercise intervention with a delayed ACLR option) studies (Group 1 = 2010.8 ± 9; Group 2 = 2015.9 ± 10; Group 3 = 2018.0 ± 4, p = 0.05). Group 2 displayed "good" quality (MCMS = 70.2 ± 7.9), while Group 1 (MCMS = 63.3 ± 6.8) and Group 3 (MCMS = 59.8 ± 6.4) displayed "fair" quality (p ≤ 0.03). Group 2 had more level 1 or 2 studies, and Group 1 had more level 4 studies (p = 0.007). Lysholm scores were similar (Group 1 = 94.4 ± 2.7, Group 2 = 92.1 ± 6.8, Group 3 = 95, p = 0.51). Group RTS rates were similar (Group 1 = 88.8 ± 14%, Group 2 = 94.1 ± 10%, Group 3 = 78.6 ± 21%; p = 0.22). Group 1 failure rates (7.4 ± 6.6%) were < Group 2 (17.0 ± 19%) (p = 0.02) and Group 3 (32.4 ± 18%) (p < 0.001). Conclusion: Although ACLR had lower failure rates, neurocognitive, reactive strength, and psychological readiness assessments were underreported. The stronger methodological rigor for ACL repair studies was encouraging but long-term outcomes are lacking.
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