Timing of Anterior Cruciate Ligament Reconstruction and Relationship With Meniscal Tears: A Systematic Review and Meta-analysis
| Autor: | Chrysoula Drosatou, Apostolos D. Prodromidis, Georgios C. Thivaios, Nasri Hani Zreik, Charalambos Panayiotou Charalambous |
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| Rok vydání: | 2020 |
| Předmět: |
Orthodontics
Adult 030222 orthopedics Anterior cruciate ligament reconstruction Anterior Cruciate Ligament Reconstruction business.industry medicine.medical_treatment Anterior cruciate ligament Anterior Cruciate Ligament Injuries Meniscal tears Physical Therapy Sports Therapy and Rehabilitation 030229 sport sciences Knee Injuries Tibial Meniscus Injuries 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Meta-analysis Medicine Humans Orthopedics and Sports Medicine Anterior Cruciate Ligament business Retrospective Studies |
| Zdroj: | The American journal of sports medicine. 49(9) |
| ISSN: | 1552-3365 |
| Popis: | Background: Anterior cruciate ligament (ACL) ruptures are common, but the ideal timing for ACL reconstruction after injury is unclear with regard to meniscal insult. Purpose: To determine whether there is a relationship between timing from ACL rupture to ACL reconstruction and development of meniscal tears within this period. Study Design: Systematic review and meta-analysis. Methods: A systematic literature search was undertaken independently by 2 reviewers using the Cochrane method for systematic reviews in 5 online databases. The reviewers performed independent data extraction and assessment of risk of bias and study quality. The search included any comparative study, including randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case-control studies of an adult population, that assessed the relationship between timing of ACL reconstruction surgery and rates of meniscal tears. Results: After screening, 12 studies (No. of participants = 3042) out of 3390 records were included for analysis: 3 RCTs (n = 272), 2 prospective cohort studies (n = 307), and 7 retrospective cohort studies (n = 2463). In analysis of these studies, rates of reported meniscal tears were compared for ACL procedures performed at 3 and 6 months after injury. Meta-analysis of 5 studies (n = 2012) showed that ACL reconstruction performed >3 months after injury was associated with a higher rate of medial meniscal tears compared with ACL reconstruction performed within 3 months of injury (estimated OR, 2.235; 95% CI, 1.183-4.223; P = .013) but not with a higher rate of lateral meniscal tears. Similarly, meta-analysis of 4 studies (n = 990) showed that ACL reconstruction performed >6 months after injury was associated with a higher rate of medial meniscal tears compared with ACL reconstruction performed within 6 months of injury (estimated OR, 2.487; 95% CI, 1.241-4.984; P = .01) but not with a higher rate of lateral meniscal tears. Conclusion: Our results suggest that delay of ACL reconstruction surgery >3 months after injury is associated with a higher rate of medial meniscal tears within this prereconstruction time frame. Further high-quality prospective studies may help determine whether this is a causal effect. However, based on current evidence, in those patients for whom ACL reconstruction is indicated, ACL reconstruction within 3 months of injury may be recommended. Registration: CRD42016032846 (PROSPERO) |
| Databáze: | OpenAIRE |
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