SynthesisFrontiers in surgery2026
Molecular cartilage pathology following anterior cruciate ligament reconstruction: a systematic review of MRI studies.
Synthesis in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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1 author.
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Abstract
Background: Anterior cruciate ligament (ACL) injury increases the risk of post-traumatic osteoarthritis. Although ACL reconstruction (ACLR) restores mechanical stability, cartilage matrix abnormalities may persist and can be detected using quantitative and compositional magnetic resonance imaging (MRI). Objectives: To synthesize MRI evidence on tibiofemoral cartilage compositional changes after ACLR, identify factors associated with worse cartilage outcomes, and summarize methodological quality and limitations of the evidence. Methods: Embase, PubMed, Web of Science, Scopus, and Cochrane Library were searched for studies published between 2000 and 2025 that evaluated tibiofemoral cartilage after ACLR using quantitative or compositional MRI. Two reviewers performed screening, data extraction, and risk-of-bias assessment. Meta-analysis was restricted to outcomes with sufficient comparability across studies; other outcomes were synthesized narratively. Results: Thirty-five studies were included. Across cohorts, ACLR knees generally demonstrated elevated cartilage T2 relaxation times and elevated T1 Limitations: Considerable variability in MRI protocols, regions of interest, and reporting limited pooling. Several studies may represent overlapping cohorts, and many analyses were underpowered. Conclusion: MRI evidence indicates that biochemical cartilage abnormalities commonly persist after ACLR, particularly in the medial tibiofemoral compartment. Standardized imaging protocols and long-term longitudinal studies linking MRI biomarkers to clinical outcomes are needed. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251156314, PROSPERO CRD420251156314.
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