Selective bundle versus complete anterior-cruciate ligament reconstruction: A systematic review and meta-analysis
Selective bundle reconstruction (SLB) refers to preservation of the intact bundle and reconstruction of the ruptured bundle in a partial tear while complete ACL reconstruction involves the removal of all remnant tissue and reconstruction of one or both bundles. As the evidence for SLB versus complet...
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Veröffentlicht in: | Journal of orthopaedics 2022-09, Vol.33, p.124-130 |
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description | Selective bundle reconstruction (SLB) refers to preservation of the intact bundle and reconstruction of the ruptured bundle in a partial tear while complete ACL reconstruction involves the removal of all remnant tissue and reconstruction of one or both bundles. As the evidence for SLB versus complete ACL reconstruction remains unclear, this study aimed to compare the two techniques. This study's hypothesis was that SLB reconstruction allows better function and stability compared to complete ACL reconstruction.
A systematic search of PubMed, EMBASE, Scopus and Cochrane Library was conducted, identifying studies that compared SLB (‘selective’ group) versus complete (‘complete’ group) ACL reconstruction. Meta-analysis was conducted for post-operative functional scores, stability outcomes and complications as well as pre-operative to post-operative change.
Eleven studies were included in the meta-analysis, with 1107 patients and a pooled mean follow-up of 29.5 months. Post-operatively, the Selective group had significantly reduced anterior laxity, shown by a lower mean arthrometry side-to-side difference (p |
doi_str_mv | 10.1016/j.jor.2022.07.015 |
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A systematic search of PubMed, EMBASE, Scopus and Cochrane Library was conducted, identifying studies that compared SLB (‘selective’ group) versus complete (‘complete’ group) ACL reconstruction. Meta-analysis was conducted for post-operative functional scores, stability outcomes and complications as well as pre-operative to post-operative change.
Eleven studies were included in the meta-analysis, with 1107 patients and a pooled mean follow-up of 29.5 months. Post-operatively, the Selective group had significantly reduced anterior laxity, shown by a lower mean arthrometry side-to-side difference (p<0.01). Analysis of change results showed that the Selective group had a lower mean improvement in arthrometry side-to-side difference as well (p<0.01). No significant difference was shown for all other post-operative outcomes.
This study provides valuable insight to the management of partial tears. It has demonstrated that the preservation of the intact bundle offers stability and function that is as good as complete reconstruction and that SLB is a potentially viable option in the management of partial tears.
Meta-analysis; Level of evidence, 4.</description><identifier>ISSN: 0972-978X</identifier><identifier>EISSN: 0972-978X</identifier><identifier>DOI: 10.1016/j.jor.2022.07.015</identifier><identifier>PMID: 35983549</identifier><language>eng</language><publisher>Elsevier B.V</publisher><subject>ACL ; Meta-analysis ; Partial tear ; Remnant bundle ; Selective bundle ; Systematic review</subject><ispartof>Journal of orthopaedics, 2022-09, Vol.33, p.124-130</ispartof><rights>2022 Professor P K Surendran Memorial Education Foundation</rights><rights>2022 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved. 2022 Professor P K Surendran Memorial Education Foundation</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-4c58264d1a1c1e967d1e764f96934bad5401f4e89bee3b505a69f31feb25516b3</citedby><cites>FETCH-LOGICAL-c428t-4c58264d1a1c1e967d1e764f96934bad5401f4e89bee3b505a69f31feb25516b3</cites><orcidid>0000-0003-3518-8907 ; 0000-0002-4879-1011</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379500/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379500/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids></links><search><creatorcontrib>Yeo, Mark HX</creatorcontrib><creatorcontrib>Seah, Shawn JS</creatorcontrib><creatorcontrib>Gatot, Cheryl</creatorcontrib><creatorcontrib>Yew, Andy</creatorcontrib><creatorcontrib>Lie, Denny</creatorcontrib><title>Selective bundle versus complete anterior-cruciate ligament reconstruction: A systematic review and meta-analysis</title><title>Journal of orthopaedics</title><description>Selective bundle reconstruction (SLB) refers to preservation of the intact bundle and reconstruction of the ruptured bundle in a partial tear while complete ACL reconstruction involves the removal of all remnant tissue and reconstruction of one or both bundles. As the evidence for SLB versus complete ACL reconstruction remains unclear, this study aimed to compare the two techniques. This study's hypothesis was that SLB reconstruction allows better function and stability compared to complete ACL reconstruction.
A systematic search of PubMed, EMBASE, Scopus and Cochrane Library was conducted, identifying studies that compared SLB (‘selective’ group) versus complete (‘complete’ group) ACL reconstruction. Meta-analysis was conducted for post-operative functional scores, stability outcomes and complications as well as pre-operative to post-operative change.
Eleven studies were included in the meta-analysis, with 1107 patients and a pooled mean follow-up of 29.5 months. Post-operatively, the Selective group had significantly reduced anterior laxity, shown by a lower mean arthrometry side-to-side difference (p<0.01). Analysis of change results showed that the Selective group had a lower mean improvement in arthrometry side-to-side difference as well (p<0.01). No significant difference was shown for all other post-operative outcomes.
This study provides valuable insight to the management of partial tears. It has demonstrated that the preservation of the intact bundle offers stability and function that is as good as complete reconstruction and that SLB is a potentially viable option in the management of partial tears.
Meta-analysis; Level of evidence, 4.</description><subject>ACL</subject><subject>Meta-analysis</subject><subject>Partial tear</subject><subject>Remnant bundle</subject><subject>Selective bundle</subject><subject>Systematic review</subject><issn>0972-978X</issn><issn>0972-978X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9UU2LFDEQDaK46-gP8NZHL93mOx0FYVn8ggUPKngL6XT1miGdzCbpkfn3ZplF9OKpilf1XhXvIfSS4IFgIl_vh33KA8WUDlgNmIhH6BJrRXutxh-P_-ov0LNS9hgzKiR7ii6Y0CMTXF-iu68QwFV_hG7a4hygO0IuW-lcWg8BKnQ2Vsg-5d7lzXnbkOBv7QqxdhlciqU2vPoU33RXXTmVCqut3rXh0cOvRp-7FartbbThVHx5jp4sNhR48VB36PuH99-uP_U3Xz5-vr666R2nY-25EyOVfCaWOAJaqpmAknzRUjM-2VlwTBYOo54A2CSwsFIvjCwwUSGInNgOvTvrHrZphdm1h7MN5pD9avPJJOvNv5Pof5rbdDSaKS2aVzv06kEgp7sNSjWrLw5CsBHSVgxVmI9SjZS2VXJedTmVkmH5c4Zgcx-V2ZsWlbmPymBlWlSN8_bMgWZCsyqb4jxEB7NvvlYzJ_8f9m8Qpp7y</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Yeo, Mark HX</creator><creator>Seah, Shawn JS</creator><creator>Gatot, Cheryl</creator><creator>Yew, Andy</creator><creator>Lie, Denny</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3518-8907</orcidid><orcidid>https://orcid.org/0000-0002-4879-1011</orcidid></search><sort><creationdate>20220901</creationdate><title>Selective bundle versus complete anterior-cruciate ligament reconstruction: A systematic review and meta-analysis</title><author>Yeo, Mark HX ; Seah, Shawn JS ; Gatot, Cheryl ; Yew, Andy ; Lie, Denny</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-4c58264d1a1c1e967d1e764f96934bad5401f4e89bee3b505a69f31feb25516b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>ACL</topic><topic>Meta-analysis</topic><topic>Partial tear</topic><topic>Remnant bundle</topic><topic>Selective bundle</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yeo, Mark HX</creatorcontrib><creatorcontrib>Seah, Shawn JS</creatorcontrib><creatorcontrib>Gatot, Cheryl</creatorcontrib><creatorcontrib>Yew, Andy</creatorcontrib><creatorcontrib>Lie, Denny</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yeo, Mark HX</au><au>Seah, Shawn JS</au><au>Gatot, Cheryl</au><au>Yew, Andy</au><au>Lie, Denny</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Selective bundle versus complete anterior-cruciate ligament reconstruction: A systematic review and meta-analysis</atitle><jtitle>Journal of orthopaedics</jtitle><date>2022-09-01</date><risdate>2022</risdate><volume>33</volume><spage>124</spage><epage>130</epage><pages>124-130</pages><issn>0972-978X</issn><eissn>0972-978X</eissn><abstract>Selective bundle reconstruction (SLB) refers to preservation of the intact bundle and reconstruction of the ruptured bundle in a partial tear while complete ACL reconstruction involves the removal of all remnant tissue and reconstruction of one or both bundles. As the evidence for SLB versus complete ACL reconstruction remains unclear, this study aimed to compare the two techniques. This study's hypothesis was that SLB reconstruction allows better function and stability compared to complete ACL reconstruction.
A systematic search of PubMed, EMBASE, Scopus and Cochrane Library was conducted, identifying studies that compared SLB (‘selective’ group) versus complete (‘complete’ group) ACL reconstruction. Meta-analysis was conducted for post-operative functional scores, stability outcomes and complications as well as pre-operative to post-operative change.
Eleven studies were included in the meta-analysis, with 1107 patients and a pooled mean follow-up of 29.5 months. Post-operatively, the Selective group had significantly reduced anterior laxity, shown by a lower mean arthrometry side-to-side difference (p<0.01). Analysis of change results showed that the Selective group had a lower mean improvement in arthrometry side-to-side difference as well (p<0.01). No significant difference was shown for all other post-operative outcomes.
This study provides valuable insight to the management of partial tears. It has demonstrated that the preservation of the intact bundle offers stability and function that is as good as complete reconstruction and that SLB is a potentially viable option in the management of partial tears.
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subjects | ACL Meta-analysis Partial tear Remnant bundle Selective bundle Systematic review |
title | Selective bundle versus complete anterior-cruciate ligament reconstruction: A systematic review and meta-analysis |
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