Bridge enhanced ACL repair vs. ACL reconstruction for ACL tears: A systematic review and meta-analysis of comparative studies

Introduction: Anterior cruciate ligament (ACL) tear is one of the most frequent ligamentous injuries. The gold standard for ACL tears is autograft reconstruction. However, ACL repair has regained enthusiasm with more recent results showing comparable outcomes to its reconstructive counterpart. Methods: PubMed, Cochrane, and Google Scholar (pp. 1–20) were searched until November 2022. The clinical outcomes consisted of the International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), the side-to-side difference in Anteroposterior (AP) knee laxity, the forces of the hamstring, quadriceps, and hip abduction as well as hopping tests. Results: Only two studies were included in this meta-analysis. ACL repair was shown to have better Hamstrings strength. The rest of the analyzed outcomes were comparable. Discussion: This is the first meta-analysis comparing these two treatments. The ACL repair showed no differences in muscle strength (quadriceps and hip abductors), postoperative knee scores, and knee joint laxity when compared to ACL reconstruction. However, it showed better hamstring strength. Further randomized clinical studies will be needed to compare both of these techniques.