Background
Methods
Literature search and study selection
Assessment of methodological quality
Data extraction
Study name | Period | Study design, Level of evidence | No. of patients | Age | Follow-up time | Quality assessment | ||
All- inside | Full tibial tunnel | All- inside | Full tibial tunnel | |||||
All-inside VS full tibial tunnel | ||||||||
Desai et al., 2019 [8] | July 2011 to July 2015 | Cohort study; Level 3. | 82 | 54 | 25.8 ± 10.2 | 21.1 ± 7.3 | All-inside: 30.1 mons, Full tibial tunnel: 25.8 mons | b8 |
Kouloumentas et al., 2019 [3] | 2015 to 2016 | RCT; level 1 | 45 | 45 | 27.6 ± 11.4 | 29.7 ± 11.0 | 24 mons | a5 |
Mayr et al., 2019 [9] | 2013 to 2016 | RCT; Level 2 | 17 | 16 | 26 ± 6 | 29 ± 7 | 24 mons | a2 |
Monaco et al., 2018 [10] | Jan 2016 to June 2016 | Cohort study; Level 3 | 22 | 22 | 32.5 ± 6.7 | 31.7 ± 7.1 | 24 mons | b8 |
Baldassarri et al., 2018 [11] | Nov 2012 to Sep 2013 | RCT; Level 2 | 28 | 31 | 24.7 | 25.2 | 48 mons | a2 |
Volpi et al., 2014 [12] | 2007 to 2008 | Cohort study; Level 3 | 20 | 20 | 38.4 ± 10.8 | 32.6 ± 9.3 | 24 mons | b5 |
Benea et al., 2013 [13] | Dec 2010 to Sep 2011 | RCT; Level 1 | 22 | 22 | 28.4 ± 8.6 | 30.2 ± 9.4 | 6 mons | a3 |
Suspensory cortical button fixation (suspensory fixation) VS Resorbable interference screw fixation (interference screw) | ||||||||
Suspensory fixation | Interference screw | Suspensory fixation | Interference screw | |||||
cColombet et al., 2016 [14] | Feb 2014 to Sep 2014 | Prospective cohort study; level 2 | 60 | 49 | 28.9 ± 9.5 | 27.6 ± 6.8 | 6.6 mons | b8 |
cLubowitz et al., 2015 [15] | NA | RCT; Level 1 | 31 | 27 | 40.2 ± 11.9 | 41.6 ± 9.1 | 24 mons | a3 |
Statistical analysis
Results
Study selection and critical appraisal
Author, year | Outcome measurement | Graft type/Graft thickness | Fixation material | ||
All-inside | Full tibial tunnel | All-inside | Full tibial tunnel | ||
All-inside VS full tibial tunnel | |||||
Desai et al., 2019 [8] | Lachman test, pivot shift, Tegner activity scale, Lysholm score, IKDC score, and complications (includes graft failure) | ST4 (74.4%), 9.0 mm (range, 8.0–10.5 mm; SD, 0.6 mm) | DGST, 8.3 mm (range, 7.0–10.0 mm; SD,–0.7 mm) | Femoral side: TightRope (Arthrex), Tibial side: GraftLink (Arthrex) | Femoral side: Endobutton (Smith &Nephew)(65%), TightRope (Arthrex)(34%), or RetroButton (Arthrex)(1%) Tibial side: Interference screw Bio-Compression Screw (Arthrex) |
Kouloumentas et al., 2019 [3] | Lysholm score, IKDC score, KOOS, KSS, knee laxity assessment (use KT-1000 arthrometer), isokinetic testing, and graft failure | ST4, Femoral side:8.2 ± 0.7 mm Tibial side: 8.3 ± 5.0 mm | DGST, Femoral side: 7.7 ± 0.5 mm Tibial side: 7.7 ± 4.9 mm | Both femoral and tibial side: TightRope (Arthrex) | Femoral side: Flipptack™ button system (Karl Storz, Tuttlingen) Tibial side: interference screw - Megafix (Karl Storz, Tuttlingen). |
Mayr et al., 2019 [9] | Pivot shift, Tegner activity scores, Lysholm score, IKDC score, knee laxity assessment (use KT-1000 arthrometer), hop testing, and tunnel diameter and volume measured with CT scans | ST4, Femoral side: 7.7 ± 0.8 mm Tibial side: 8.0 ± 0.5 mm | DGST, Femoral side: 7.3 ± 0.5 mm Tibial side: 7.9 ± 0.8 mm | Both femoral and tibial side: TightRope (Arthrex) | Both femoral and tibial side: Interference screw-BioComposite (Arthrex) |
Monaco et al., 2018 [10] | Tegner activity score, Lysholm scores, IKDC score, KSS, knee laxity assessment (use KT-1000 arthrometer), and tunnel diameter measured with CT scans | ST4 | DGST | Both femoral and tibial side: TightRope (Arthrex) | Femoral side: TightRope (Arthrex) Tibial side: interference screw- Deltascrew (Arthrex) |
Baldassarri et al., 2018 [11] | Marx score, Tegner activity score, IKDC score, and return to sport | NA | NA | Both femoral and tibial side: suspensory cortical buttons | Both femoral and tibial side: Interference screw |
Volpi et al., 2014 [12] | Tegner activity score, Lysholm score, IKDC score, VAS | ST4 | DGST | Both femoral and tibial side: suspensory cortical buttons | Femoral side: Interference screw or cortical suture button Tibial side: interference screw |
Benea et al., 2013 [13] | IKDC score, VAS, knee laxity assessment (use Rollimeter arthrometer), tunnel position measured with X-ray | ST4 | DGST | Femoral side: Tightrope (Arthrex) Tibial side: SutureButton (Arthrex) | Femoral side: Interference screw Tibial side: Interference screw |
Suspensory cortical button fixation (suspensory fixation) VS Resorbable interference screw fixation (interference screw) | |||||
Suspensory fixation | Interference screw | Suspensory fixation | Interference screw | ||
aColombet et al., 2016 [14] | knee laxity assessment (use GeNouRoB arthrometer), Graft and tunnel measurement with MRI | ST4 | ST4 | Both femoral and tibial side: PULLUP (Science & BioMaterials) suspensory system | Femoral side: PULLUP (Science & BioMaterials) suspensory system Tibial side: Interference screw (LIGAFIX 60 (Science & BioMaterials)) |
aLubowitz et al., 2015 [15] | IKDC score, KSS, SF-12 score, VAS, narcotic consumption, knee laxity assessment (use KT-1000 arthrometer), and tunnel diameter measured with X-ray | 2-strand tibialis posterior tendon | 2-strand tibialis posterior tendon | Femoral side: RetroButton (Arthrex) Tibial side: Titanium cortical button (Arthrex) | Femoral side: Interference screw-BioComposite (Arthrex) Tibial side: interference screw- RetroScrew (Arthrex) |
Results of individual studies
Graft harvest and fixation device
Graft size and flexion strength
Functional outcomes
Lysholm score
Subjective and objective IKDC score
All- inside group | Full tibial tunnel | P-value | |
---|---|---|---|
IKDC A | 86 | 93 | 0.189 |
IKDC B | 35 | 33 | |
IKDC C | 9 | 3 | |
IKDC D | 0 | 0 |