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Is all-inside with suspensory cortical button fixation a superior technique for anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis
Chun Wei Fu
Mackay Memorial Hospital
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Musculoskeletal Disorders.
Background To compare the clinical results of all-inside anterior cruciate ligament reconstruction (ACLR) using suspensory cortical button fixation and full tibial tunnel drilling
Methods Systematic searches were conducted of published literature up to November 2019 on PubMed, Embase, and Cochrane for studies comparing all-inside ACLR using suspensory cortical button fixation and full tibial tunnel ACLR. Two reviewers independently determined eligibility, extracted the outcome data, and assessed the risk of bias of the eligible studies. The clinical outcome and graft reruptures were pooled by using random effects with mean differences and risk ratios for continuous and dichotomous variables, respectively.
Result A total of nine studies (five randomized controlled trials and four comparative studies) involving 613 patients were included in the meta-analysis. The postoperative functional outcome, knee laxity measured with arthrometer, and graft reruptures were comparable between patients with all-inside ACLR using suspensory cortical button fixation and full tibial tunnel ACLR. However, a significantly greater thickness of autologous tendon was used and less change in drilling tunnel diameter was noted in patients with suspensory cortical button graft fixation.
Conclusions All-inside ACLR with suspensory cortical button fixation was not clinically superior to full tibial tunnel ACLR with interference screw fixation in functional outcomes, knee laxity measured with arthrometer, or rerupture rate. However, the advantage of using suspensory cortical button fixation was that a thicker graft could be used for reconstruction, and brought less tibia tunnel widening compared with bioabsorbable interference screw fixation.
Keywords
Anterior cruciate ligament, ACL reconstruction, All-inside, Suspensory fixation, Interference screws
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CURRENT STATUS: Published
Version 3
Posted 19 Jun, 2020
Published
On 07 Jul, 2020
No community comments so far
Editorial decision: Accept
On 01 Jul, 2020
Review #2 received
Received 29 Jun, 2020
Reviewer #2 agreed
On 28 Jun, 2020
Review #1 received
Received 27 Jun, 2020
Reviewers invited
Invitations sent on 22 Jun, 2020
Reviewer #1 agreed
On 22 Jun, 2020
Editor assigned
On 18 Jun, 2020
Submission checks complete
On 17 Jun, 2020
Editor invited
On 17 Jun, 2020
No comments provided
Review #3 received
Received 28 May, 2020
Editorial decision: Major revision
On 28 May, 2020
Review #2 received
Received 10 May, 2020
Reviewer #3 agreed
On 05 May, 2020
Reviewer #2 agreed
On 30 Apr, 2020
Reviewer #1 agreed
On 21 Apr, 2020
Review #1 received
Received 21 Apr, 2020
Editor assigned
On 20 Apr, 2020
Reviewers invited
Invitations sent on 20 Apr, 2020
Submission checks complete
On 19 Apr, 2020
Editor invited
On 19 Apr, 2020
No comments provided
Review #2 received
Received 07 Apr, 2020
Editorial decision: Major revision
On 07 Apr, 2020
Reviewer #2 agreed
On 26 Mar, 2020
Reviewer #1 agreed
On 20 Mar, 2020
Review #1 received
Received 20 Mar, 2020
Submission checks complete
On 17 Mar, 2020
Editor invited
On 17 Mar, 2020
Editor assigned
On 17 Mar, 2020
Reviewers invited
Invitations sent on 17 Mar, 2020
First submitted
On 11 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
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This preprint is under consideration at BMC Musculoskeletal Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Is all-inside with suspensory cortical button fixation a superior technique for anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis
Chun Wei Fu
Mackay Memorial Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 19 Jun, 2020
Published
On 07 Jul, 2020
No community comments so far
Editorial decision: Accept
On 01 Jul, 2020
Review #2 received
Received 29 Jun, 2020
Reviewer #2 agreed
On 28 Jun, 2020
Review #1 received
Received 27 Jun, 2020
Reviewers invited
Invitations sent on 22 Jun, 2020
Reviewer #1 agreed
On 22 Jun, 2020
Editor assigned
On 18 Jun, 2020
Submission checks complete
On 17 Jun, 2020
Editor invited
On 17 Jun, 2020
No comments provided
Review #3 received
Received 28 May, 2020
Editorial decision: Major revision
On 28 May, 2020
Review #2 received
Received 10 May, 2020
Reviewer #3 agreed
On 05 May, 2020
Reviewer #2 agreed
On 30 Apr, 2020
Reviewer #1 agreed
On 21 Apr, 2020
Review #1 received
Received 21 Apr, 2020
Editor assigned
On 20 Apr, 2020
Reviewers invited
Invitations sent on 20 Apr, 2020
Submission checks complete
On 19 Apr, 2020
Editor invited
On 19 Apr, 2020
No comments provided
Review #2 received
Received 07 Apr, 2020
Editorial decision: Major revision
On 07 Apr, 2020
Reviewer #2 agreed
On 26 Mar, 2020
Reviewer #1 agreed
On 20 Mar, 2020
Review #1 received
Received 20 Mar, 2020
Submission checks complete
On 17 Mar, 2020
Editor invited
On 17 Mar, 2020
Editor assigned
On 17 Mar, 2020
Reviewers invited
Invitations sent on 17 Mar, 2020
First submitted
On 11 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Musculoskeletal Disorders.
Background To compare the clinical results of all-inside anterior cruciate ligament reconstruction (ACLR) using suspensory cortical button fixation and full tibial tunnel drilling
Methods Systematic searches were conducted of published literature up to November 2019 on PubMed, Embase, and Cochrane for studies comparing all-inside ACLR using suspensory cortical button fixation and full tibial tunnel ACLR. Two reviewers independently determined eligibility, extracted the outcome data, and assessed the risk of bias of the eligible studies. The clinical outcome and graft reruptures were pooled by using random effects with mean differences and risk ratios for continuous and dichotomous variables, respectively.
Result A total of nine studies (five randomized controlled trials and four comparative studies) involving 613 patients were included in the meta-analysis. The postoperative functional outcome, knee laxity measured with arthrometer, and graft reruptures were comparable between patients with all-inside ACLR using suspensory cortical button fixation and full tibial tunnel ACLR. However, a significantly greater thickness of autologous tendon was used and less change in drilling tunnel diameter was noted in patients with suspensory cortical button graft fixation.
Conclusions All-inside ACLR with suspensory cortical button fixation was not clinically superior to full tibial tunnel ACLR with interference screw fixation in functional outcomes, knee laxity measured with arthrometer, or rerupture rate. However, the advantage of using suspensory cortical button fixation was that a thicker graft could be used for reconstruction, and brought less tibia tunnel widening compared with bioabsorbable interference screw fixation.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
Figure 8
Figure 9
Figure 10
Figure 11
Figure 12