ACL Reconstruction with Augmentation: a Scoping Review
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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.
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.
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.
KeywordsAnterior cruciate ligament Anterolateral ligament Lateral tenodesis Platelet-rich plasma Lemaire
Compliance with Ethical Standards
Conflict of Interest
Michael D. Riediger, Devon Stride, Sarah E. Coke, Adrian Z. Kurz, and Andrew Duong each declare no potential conflicts of interest.
Olufemi R. Ayeni is on the speaker’s bureau for Conmed and Smith & Nephew and is a section editor for Current Reviews in Musculoskeletal Medicine.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 7.• Ibrahim SA, Shohdy EM, Marwan Y, Ramadan SA, Almisfer AK, Mohammad MW, et al. Anatomic reconstruction of the anterior cruciate ligament of the knee with or without reconstruction of the anterolateral ligament: a randomized clinical trial. Am J Sports Med. 2017;45(7):1558–66 Randomized control trial examining outcomes of ACL vs ACL + ALL reconstruction directly. Authors found no difference in outcomes over 2-year follow-up period. Largest RCT identified for ACL + ALL reconstruction identified for this review. CrossRefGoogle Scholar
- 8.Thaunat M, Clowez G, Saithna A, Cavalier M, Choudja E, Vieira TD, et al. Reoperation rates after combined anterior cruciate ligament and anterolateral ligament reconstruction: a series of 548 patients from the SANTI study group with a minimum follow-up of 2 years. Am J Sports Med. 2017;45(11):2569–77.CrossRefGoogle Scholar
- 9.Sonnery-Cottet B, Saithna A, Cavalier M, Kajetanek C, Temponi EF, Daggett M, et al. Anterolateral ligament reconstruction is associated with significantly reduced ACL graft rupture rates at a minimum follow-up of 2 years: a prospective comparative study of 502 patients from the SANTI study group. Am J Sports Med. 2017;45(7):1547–57.CrossRefGoogle Scholar
- 11.Zaffagnini S, Marcheggiani Muccioli GM, Grassi A, Roberti di Sarsina T, Raggi F, Signorelli C, et al. Over-the-top ACL reconstruction plus extra-articular lateral tenodesis with hamstring tendon grafts: prospective evaluation with 20-year minimum follow-up. Am J Sports Med. 2017;45(14):3233–42.CrossRefGoogle Scholar
- 12.Imbert P, Lustig S, Steltzlen C, Batailler C, Colombet P, Dalmay F, et al. Midterm results of combined intra- and extra-articular ACL reconstruction compared to historical ACL reconstruction data. Multicenter study of the French Arthroscopy Society. Orthop Traumatol Surg Res. 2017;103(8):S215–21.CrossRefGoogle Scholar
- 14.Panisset JC, Pailhé R, Schlatterer B, Sigwalt L, Sonnery-Cottet B, Lutz C, et al. Short-term complications in intra- and extra-articular anterior cruciate ligament reconstruction. Comparison with the literature on isolated intra-articular reconstruction. A multicenter study by the French Arthroscopy Society. Orthop Traumatol Surg Res. 2017;103(8):S231–6.CrossRefGoogle Scholar
- 15.Alessio-Mazzola M, Formica M, Russo A, Sanguineti F, Capello A, Lovisolo S, et al. Outcome after combined lateral extra-articular tenodesis and anterior cruciate ligament revision in professional soccer players. J Knee Surg [Internet]. 2018 Sep 18 [cited 2018 Dec 5]; Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1672120.
- 16.Walters BL, Porter DA, Hobart SJ, Bedford BB, Hogan DE, McHugh MM, et al. Effect of intraoperative platelet-rich plasma treatment on postoperative donor site knee pain in patellar tendon autograft anterior cruciate ligament reconstruction: a double-blind randomized controlled trial. Am J Sports Med. 2018;46(8):1827–35.CrossRefGoogle Scholar
- 23.•• Hexter AT, Thangarajah T, Blunn G, Haddad FS. Biological augmentation of graft healing in anterior cruciate ligament reconstruction: a systematic review. Bone Jt J. 2018;100-B(3):271–84 Excellent systemic review examining all of the studies involving biological augmentation of ACL surgery including basic science and animal models which for the purpose of this article were only mentioned briefly as they were not in clinical trials yet. CrossRefGoogle Scholar
- 26.Lu H, Chen C, Xie S, Tang Y, Qu J. Tendon healing in bone tunnel after human anterior cruciate ligament reconstruction: a systematic review of histological results. J Knee Surg [Internet]. 2018 May 21 [cited 2018 Dec 17]; Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1653964.
- 31.Cervellin M, de Girolamo L, Bait C, Denti M, Volpi P. Autologous platelet-rich plasma gel to reduce donor-site morbidity after patellar tendon graft harvesting for anterior cruciate ligament reconstruction: a randomized, controlled clinical study. Knee Surg Sports Traumatol Arthrosc. 2012;20(1):114–20.CrossRefGoogle Scholar
- 37.Vaquette C, Viateau V, Guérard S, Anagnostou F, Manassero M, Castner DG, et al. The effect of polystyrene sodium sulfonate grafting on polyethylene terephthalate artificial ligaments on in vitro mineralisation and in vivo bone tissue integration. Biomaterials. 2013;34(29):7048–63.CrossRefGoogle Scholar
- 38.Bi F, Shi Z, Liu A, Guo P, Yan S. Anterior cruciate ligament reconstruction in a rabbit model using silk-collagen scaffold and comparison with autograft. Liu X, editor PLOS ONE 2015;10(5):e0125900.Google Scholar