2025 ISAKOS Biennial Congress ePoster
Graft Choice For Anterior Cruciate Ligament Reconstruction With Concurrent Lateral Extra-Articular Procedure: A Systematic Review And Network Meta-Analysis Of Randomized Controlled Trials
Jusung Lee, MD KOREA, REPUBLIC OF
Sung-Hwan Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Min Jung, MD, PhD, Seoul KOREA, REPUBLIC OF
Hyun-Soo Moon, MD, PhD, Seoul KOREA, REPUBLIC OF
Se-Han Jung, MD, Seoul KOREA, REPUBLIC OF
Kwangho Chung, MD, Seoul KOREA, REPUBLIC OF
Yonsei University College of Medicine, seoul, KOREA, REPUBLIC OF
FDA Status Cleared
Summary
HT graft ACLR with LEP was superior to isolated ACLR in terms of graft rupture, graft failure, and clinical failure rates. BPTB graft ACLR with LEP also showed better clinical failure rates compared to isolated ACLR. Although all groups showed significant improvements in clinical outcome scores at follow-up, the differences were not clinically relevant.
ePosters will be available shortly before Congress
Abstract
Purpose
To systematically review the current randomized controlled trials (RCTs) and conduct a network meta-analysis (NMA) to assess and compare graft failure and clinical outcomes, focusing on the graft choice in anterior cruciate ligament reconstruction (ACLR) with concomitant lateral extra-articular procedure (LEP).
Methods
A systematic search was performed on PubMed, Embase, Cochrane Library, and Google Scholar to identify RCTs involving primary ACLR with concomitant LEP. Data on graft failure, residual pivot shift, residual anterior-posterior (AP) laxity, International Knee Documentation Committee (IKDC) scores, Lysholm scores, Tegner scores, and documented complications were collected. Subsequently, a NMA was conducted on this dataset.
Results
In the meta-analysis of included 13 studies with 1935 patients, ACLR using a hamstring tendon (HT) graft with LEP showed significantly lower graft rupture (odds ratio, OR: 0.28, 95% CI: 0.16 to 0.52), graft failure (OR: 0.28, 95% CI: 0.16 to 0.52) and clinical failure (OR: 0.48, 95% CI: 0.35 to 0.65) compared to isolated ACLR. ACLR using a bone-patellar tendon-bone (BPTB) graft with LEP showed significantly lower clinical failure (OR: 0.30, 95% CI: 0.12 to 0.80) compared to isolated ACLR. ACLR with an HT graft with LEP showed significantly lower residual pivot shift rates (OR: 0.46, 95% CI: 0.22 to 0.94) compared to isolated ACLR. ACLR with an HT graft with LEP (MD: 2.22, 95% CI: 0.80 to 3.63) and ACLR with a BPTB graft with LEP (mean difference, MD: 3.70, 95% CI: 0.85 to 6.55) showed significantly higher Lysholm scores compared to isolated ACLR.
Conclusion
In graft rupture, graft failure and clinical failure rates, ACLR using a HT graft with LEP is superior to isolated ACLR. ACLR using a BPTB graft with LEP showed a superiority in clinical failure rates compared to isolated ACLR. Clinical outcome scores improved significantly in all groups at follow-up, but differences were not clinically relevant.