Michael D Riediger1, Devon Stride1, Sarah E Coke2, Adrian Z Kurz1, Andrew Duong1, Olufemi R Ayeni3,4. 1. Division of Orthopaedic Surgery, Department of Surgery, Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada. 2. Department of Medicine, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada. 3. Division of Orthopaedic Surgery, Department of Surgery, Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada. ayenif@mcmaster.ca. 4. McMaster University Medical Center, 1200 Main St W, Room 4E15, Hamilton, Ontario, L8N 3Z5, Canada. ayenif@mcmaster.ca.
Abstract
PURPOSE OF REVIEW: We reviewed the recent literature to identify and summarize new research surrounding anterior cruciate ligament reconstruction (ACLR) with augmentation in the form of additional soft tissue procedures or biologic augmentation. Specifically, we wanted to review the failure rates of these procedures in both the primary and revision settings. METHODS: The databases Embase, PubMed, and Medline were searched on August 13, 2018, for English-language studies that reported on the use of anterior cruciate ligament reconstruction (primary and revision) in conjunction with either soft tissue or biologic augmentation. The studies were systematically screened and data abstracted in duplicates. RECENT FINDINGS: Advancements in ACLR surgery, including soft tissue augmentation, may decrease primary and revision surgery failure rates for high-risk patients. The use of biological augmentation has shown histologic and radiographic improvements. These differences, however, have failed to be statistically significant and have not resulted in clinically significant improvements in outcome. The limited body of evidence has shown that the addition of soft tissue procedures may in fact lower the risk of graft re-rupture rates particularly in revision or in patients wishing to return to high-risk sports and activities. The use of biologic augmentation although promising in laboratory studies has yet to show any significant clinical results and therefore will require further studies to prove any efficacy.
PURPOSE OF REVIEW: We reviewed the recent literature to identify and summarize new research surrounding anterior cruciate ligament reconstruction (ACLR) with augmentation in the form of additional soft tissue procedures or biologic augmentation. Specifically, we wanted to review the failure rates of these procedures in both the primary and revision settings. METHODS: The databases Embase, PubMed, and Medline were searched on August 13, 2018, for English-language studies that reported on the use of anterior cruciate ligament reconstruction (primary and revision) in conjunction with either soft tissue or biologic augmentation. The studies were systematically screened and data abstracted in duplicates. RECENT FINDINGS: Advancements in ACLR surgery, including soft tissue augmentation, may decrease primary and revision surgery failure rates for high-risk patients. The use of biological augmentation has shown histologic and radiographic improvements. These differences, however, have failed to be statistically significant and have not resulted in clinically significant improvements in outcome. The limited body of evidence has shown that the addition of soft tissue procedures may in fact lower the risk of graft re-rupture rates particularly in revision or in patients wishing to return to high-risk sports and activities. The use of biologic augmentation although promising in laboratory studies has yet to show any significant clinical results and therefore will require further studies to prove any efficacy.
Authors: Allan Felipe Fattori Alves; José Ricardo de Arruda Miranda; Sérgio Augusto Santana de Souza; Ricardo Violante Pereira; Paulo Roberto de Almeida Silvares; Seizo Yamashita; Elenice Deffune; Diana Rodrigues de Pina Journal: J Orthop Surg Res Date: 2021-04-28 Impact factor: 2.359