Comparison of Anterior Cruciate Ligament Reconstruction with and without Suture-tape Augmentation: A Meta-analysis

Abstract One of the most frequent knee injuries is anterior cruciate ligament (ACL) injury. ACL reconstruction (ACLR) remains the gold standard for the treatment of ACL injuries. The augmentation of ACLR with Suture tape augmentation (STA) has been shown to provide promising results. This study aimed to compare patient-reported outcomes such as International Knee Documentation Committee (IKDC) Score, Lysholm score, Tegner score, single assessment numeric evaluation (SANE), rate of graft failure, complications, and return to sport among patients who underwent ACLR with and without STA. A Literature search was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines. Databases PubMed, Google Scholar, and Cochrane Library were reviewed for randomized controlled trial and cohort studies that compared ACLR with and without STA up to August 2022. Patient-reported outcomes were meta-analyzed and summarized. To compare postoperative result between ACLR with and without STA, summary event rates for graft failure, complication, and return to sport were calculated. Four studies were included, involving 289 participants. In general, the results of this meta-analysis indicated that the STA group was better in most of the clinical outcomes. Statistically significant differences in favor of STA were observed for IKDC Score (weighted mean difference WMD =2.08; P = 0.04), Lysholm score (WMD = 2.63; P = 0.09), Tegner score (WMD = 0.70; P < 0.00001), and SANE (WMD = 4.24; P = 0.01). When analyzing the graft failure (odds ratio = 0.41; P = 0.09) and return to sport (WMD = −0.25; P = 0.19), the two groups showed no significant difference. This study demonstrates that ACLR with STA was associated with better clinical outcomes compared to ACLR alone. In terms of rate of graft failure and return to sport, the STA group was not superior.