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Augmentation with Fibertape Leads to Biomechanically Superior but Similar Clinical Outcomes in ACL Surgeries: Systematic Review and Meta-analysis

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Abstract

Purpose

The current generation has witnessed significant progress in the field of knee arthroscopy. Suture tapes have gained immense popularity due to perceived improved biomechanical support to the graft while it heals. The purpose of the present systematic review is to analyze the biomechanical construct of suture tapes in ACL repairs and reconstructions along with clinical outcomes.

Methods

Cochrane Library, PubMed, and Embase were searched until December 2021. All Biomechanical Studies on animal or cadaver knees that compared construct characteristics of suture tape in ACL repair or reconstruction and clinical studies in English focusing on outcomes following suture tape augmentation in ACL repair or reconstruction were included. The quality of clinical studies using the Modified Coleman Methodology Score (MCMS).

Results

A total of 16 studies biomechanical and 23 clinical studies were included in qualitative synthesis, leaving nine biomechanical studies for final quantitative analyses. Suture tape revealed biomechanical superiority in terms of ultimate strength, stiffness, cyclic displacement, and elongation of graft, while comparing ACLR with internal brace to standard ACLR. No significant difference in retear rates was seen in clinical studies. Clinical score(IKDC score) was found similar in both augmented and non-augmented construct. Similar results were obtained in biomechanical studies.

Conclusion

The use of suture tape as a ligament augmentation in both ACL reconstruction and ACL repair offers more strength, less elongation or displacement, and is biomechanically stable and sound. There is a lack of data to comprehensively comment upon the clinical superiority of the use of internal augmentation. However, a meta-analysis of the retear rates and clinical outcome score revealed similar outcomes between suture tape augmented and nonaugmented groups.

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Data Availability

All included studies used in this systematic review and meta-analysis are available online. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Data regarding this study is not available in any electronic databases.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India

    Balgovind S. Raja, Aditya K. S. Gowda, Vikas K. Maheshwari & Anil Regmi

  2. Department of Orthopaedics, Fortis Hospital, Mohali, Punjab, India

    Manit Arora

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  1. Balgovind S. Raja
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  2. Manit Arora
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  3. Aditya K. S. Gowda
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Contributions

BSR—Planning of study, literature search, writing the manuscript, quality assessment of the included studies. MA – Data management, outcome assessment, manuscript preparation, revising the manuscript. VM—Literature search, writing the manuscript, quality assessment of the included studies. AKSG—Data management, outcome assessment, manuscript preparation. AR—Planning of study, quality assessment of the included studies, writing and revising the manuscript.

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Correspondence to Balgovind S. Raja.

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Raja, B.S., Arora, M., Gowda, A.K.S. et al. Augmentation with Fibertape Leads to Biomechanically Superior but Similar Clinical Outcomes in ACL Surgeries: Systematic Review and Meta-analysis. JOIO 57, 722–747 (2023). https://doi.org/10.1007/s43465-022-00805-2

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