ArticleBioengineering (Basel, Switzerland)2026
A Research Hotspot-Guided Meta-Analysis of Anterior Closing-Wedge High Tibial Osteotomy in Revision Anterior Cruciate Ligament Reconstruction.
Article in Bioengineering (Basel, Switzerland), 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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Abstract
backgroundRevision anterior cruciate ligament reconstruction (ACLR) presents an increasing clinical challenge with higher failure rates than primary reconstruction. However, the evolving research landscape and clinical evidence regarding key biomechanical risk factors remain incompletely synthesized.
methodsA sequential dual methodological approach was applied. First, a bibliometric analysis of the Web of Science Core Collection was performed to map global research trends and identify emerging hotspots. Based on the identified hotspot, a PRISMA-compliant meta-analysis of studies retrieved from PubMed, Embase, the Cochrane Library, and Web of Science was subsequently conducted. Clinical and radiographic outcomes were synthesized using random-effects models in R.
resultsThe bibliometric analysis included 4213 publications and demonstrated exponential growth in revision ACLR research, identifying posterior tibial slope (PTS) as the dominant research hotspot. A meta-analysis of 11 studies involving 299 patients showed significant postoperative improvements in patient-reported outcomes and objective knee stability measures, along with a mean PTS reduction of 8.72° (95% CI 7.84-9.60;
conclusionsPTS has emerged as a key focus in revision ACLR research, and addressing this biomechanical factor may be associated with improved functional and radiographic outcomes. However, current evidence is mainly derived from retrospective studies, and further prospective research is needed to confirm long-term efficacy and refine surgical indications.
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