Comparison of efficacy and safety of different fixation devices for anterior cruciate ligament reconstruction: A Bayesian network meta-analysis protocol

BACKGROUND: Anterior cruciate ligament (ACL) injury is a common ligament injury to the knee joint, and often lead to limited function, osteoarthritis after knee trauma, secondary damage to meniscus and cartilage, and impaired quality of life. ACL reconstruction is the gold standard surgical treatment for ACL injury, and ligament fixation after reconstruction is the key factor of ACL reconstruction success. However, the optimal fixation device for ACL reconstruction remains unclear. This study aims to evaluate the efficacy and safety of different fixation devices and to find the best fixation device for ACL reconstruction. METHODS: The PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Chinese Biomedicine Literature will be searched to identify relevant studies from inception to December 2018. We will include randomized controlled trials (RCTs) comparing the effects of different fixation devices fixed on the femoral side in arthroscopically assisted ACL reconstruction. Risk of bias assessment of the included RCTs will be conducted according to the Cochrane Handbook 5.1.0. A Bayesian network meta-analysis (NMA) will be performed using R software. RESULTS: The results of this NMA will be submitted to a peer-reviewed journal for publication. CONCLUSION: This NMA will summarize the direct and indirect evidence to evaluate the effect of different fixation devices for ACL reconstruction.