Functional and Return-to-Sport Outcomes After Biologic Augmentation in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background The clinical value of biologic augmentation during anterior cruciate ligament reconstruction remains uncertain, particularly regarding functional recovery and return to sport. Existing evidence has yielded inconsistent results, and prior syntheses have often emphasized radiologic outcomes rather than patient-centered functional measures. Methods A systematic review and random-effects meta-analysis of comparative clinical studies evaluating biologic augmentation during anterior cruciate ligament reconstruction was conducted. PubMed, the Cochrane Library, and Google Scholar were searched without date restrictions. Tegner activity score, Lysholm knee score, International Knee Documentation Committee score, and return-to-sport outcomes were analyzed when available. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool and the MINORS criteria. Results Ten studies were included. Biologic augmentation was associated with higher Tegner activity scores compared with standard reconstruction, with a pooled mean difference of 0.52 (95% confidence interval 0.14 to 0.91) and no observed heterogeneity. Lysholm knee scores were also higher in the biologic augmentation group (mean difference 3.32, 95% confidence interval 0.65 to 6.00), although substantial heterogeneity persisted across studies. No significant difference was observed in pooled International Knee Documentat

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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