Knee osteoarthritis, joint laxity and PROMs following conservative management versus surgical reconstruction for ACL rupture: a meta-analysis.

IF 6.7 2区医学 Q1 Medicine

British medical bulletin Pub Date : 2023-04-05 DOI:10.1093/bmb/ldac029

Filippo Migliorini, Francesco Oliva, Joerg Eschweiler, Ernesto Torsiello, Frank Hildebrand, Nicola Maffulli

{"title":"Knee osteoarthritis, joint laxity and PROMs following conservative management versus surgical reconstruction for ACL rupture: a meta-analysis.","authors":"Filippo Migliorini, Francesco Oliva, Joerg Eschweiler, Ernesto Torsiello, Frank Hildebrand, Nicola Maffulli","doi":"10.1093/bmb/ldac029","DOIUrl":null,"url":null,"abstract":"Introduction: Patients whose rupture of the anterior cruciate ligament (ACL) can be managed conservatively or undergo reconstruction surgery.Source of data: Current scientific literature published in Web of Science, PubMed and Scopus.Areas of agreement: Several studies published by July 2022 compare surgical and conservative management following ACL rupture. The latest evidence suggests that surgical management may expose patients to an increased risk of early-onset knee osteoarthritis (OA).Areas of controversy: The state of art does not recommend a systematic ACL reconstruction to all patients who tore their ACL. After the initial trauma, surgical reconstruction may produce even greater damage to the intra-articular structures compared to conservative management.Growing points: The state of art does not recommend systematic surgical reconstruction to all patients who tore their ACL. The present study compared surgical reconstruction versus conservative management for primary ACL ruptures in terms of joint laxity, patient reported outcome measures (PROMs) and rate of osteoarthritis.Areas timely for developing research: ACL reconstruction provides significant improvement in joint laxity compared to conservative management, but is associated with a significantly greater rate of knee osteoarthritis, despite similar results at PROM assessment.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"145 1","pages":"72-87"},"PeriodicalIF":6.7000,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British medical bulletin","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bmb/ldac029","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Patients whose rupture of the anterior cruciate ligament (ACL) can be managed conservatively or undergo reconstruction surgery.

Source of data: Current scientific literature published in Web of Science, PubMed and Scopus.

Areas of agreement: Several studies published by July 2022 compare surgical and conservative management following ACL rupture. The latest evidence suggests that surgical management may expose patients to an increased risk of early-onset knee osteoarthritis (OA).

Areas of controversy: The state of art does not recommend a systematic ACL reconstruction to all patients who tore their ACL. After the initial trauma, surgical reconstruction may produce even greater damage to the intra-articular structures compared to conservative management.

Growing points: The state of art does not recommend systematic surgical reconstruction to all patients who tore their ACL. The present study compared surgical reconstruction versus conservative management for primary ACL ruptures in terms of joint laxity, patient reported outcome measures (PROMs) and rate of osteoarthritis.

Areas timely for developing research: ACL reconstruction provides significant improvement in joint laxity compared to conservative management, but is associated with a significantly greater rate of knee osteoarthritis, despite similar results at PROM assessment.

查看原文本刊更多论文

膝关节骨性关节炎，关节松弛和PROMs保守处理与手术重建前交叉韧带破裂:荟萃分析。

简介:前交叉韧带(ACL)断裂的患者可以保守治疗或进行重建手术。数据来源:在Web of Science、PubMed和Scopus上发表的最新科学文献。共识领域:2022年7月发表的几项研究比较了前交叉韧带破裂后的手术和保守治疗。最新的证据表明，手术治疗可能会增加患者患早发性膝骨关节炎(OA)的风险。争议领域:目前尚不建议对所有前交叉韧带撕裂的患者进行系统的前交叉韧带重建。初次创伤后，与保守治疗相比，手术重建可能对关节内结构造成更大的损害。生长点:目前的技术水平并不推荐对所有前交叉韧带撕裂的患者进行系统的手术重建。本研究比较了手术重建与保守治疗原发性前交叉韧带破裂的关节松弛、患者报告的结果测量(PROMs)和骨关节炎的发生率。及时开展研究的领域:与保守治疗相比，ACL重建可显著改善关节松弛，但与膝骨关节炎的发生率显著增加相关，尽管在PROM评估中结果相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

British medical bulletin 医学-医学：内科

CiteScore

13.10

自引率

1.50%

发文量

审稿时长

>12 weeks

期刊介绍： British Medical Bulletin is a multidisciplinary publication, which comprises high quality reviews aimed at generalist physicians, junior doctors, and medical students in both developed and developing countries. Its key aims are to provide interpretations of growing points in medicine by trusted experts in the field, and to assist practitioners in incorporating not just evidence but new conceptual ways of thinking into their practice.