Table 2.
Characteristics of included studies (n = 25)
| Author | Year | Type of study | Level of evidence | Mean age (range) | Patients | Mean follow-up (mo) | Schenck classification | Surgical technique | Time to surgery (acute/staged/chronic) |
Lysholm (range) | IKDC | Coleman score |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Shapiro et al. [76] | 1995 | Retrospective case series | IV | 26.6 | 7 | 51.4 | II–IV | ACL/PCL reconstruction with allografts; collaterals repair | Acute: 9.6 days (5–14) | 74.7 (34–93) | n/a | 31 |
| Wascher et al. [84] | 1999 | Retrospective case series | IV | 27.5 (14–51) | 13 | 38.4 (24–54) |
IIIM: 54% IIIL: 46% |
ACL/PCL reconstruction; collaterals repair |
69% Acute: 11 days 31% Chronic: 11 months |
88.0 (42–100) |
B 50.0% C 42.0% D 8.0% |
38 |
| Yeh et al. [89] | 1999 | Retrospective case series | IV | 37.8 (16–65) | 23 | 27.2 ± 7.86 |
IIIM: 57% IIIL: 30% IV: 13% |
Reconstruction of PCL (autograft + 1allograft); No ACL repair; Collaterals repair | Acute: 11.5 ± 5 days | 84.1 (79–93) | n/a | 49 |
| Ohkoshi al. [62] | 2002 | Retrospective case series | IV | 28.7 (18–27) | 8 | 40.1 ±16.7 |
IIIM: 67% IIIL: 33% |
ACL/PCL reconstruction (autograft and artificial ligament); collaterals reconstruction (Autograft) |
Staged: 1: 12.8 ± 5.3 days 2. 3.8 ± 1.1 months (after achieving sufficient ROM) |
n/a |
B 77.8% C 22.2% |
43 |
| Harner al. [22] | 2004 | Retrospective cohort study | III | 28.4 | 31 | > 24.0 | III | ACL/PCL reconstruction (allograft); collaterals reconstruction (allograft) or repair |
Acute: 12 days (5–21) Chronic: 6.5 months (5 weeks–22 months) |
87.0 ± 12.7 |
B 35.0% C 39.0% D 26.0% |
54 |
| Talbot et al. [81] | 2004 | Retrospective case series | IV | 28.5 (15–73) | 20 | 27.4 |
II: 5% IIIM: 43% IIIL: 48% IV: 5% |
ACL/PCL repair and augmentation with LARS; collaterals repair and if necessary Augmentation with LARS | Acute: 11 days | 71.7 ± 18 | n/a | 57 |
| Bin et al. [5] | 2007 | Retrospective case series | IV | 30.4 (20–51) | 14 | 88.9 (35–110) |
IIIM: 47% IIIL: 33% IV: 20% |
ACL/PCL reconstruction with allo/autograft; MCL repair or conservative; LCL repair or reconstruction |
Staged: 1: < 2 Weeks to injury 2. After full ROM (3-6monts) |
87.6 |
A 20.0% B 53.0% C 27.0% |
50 |
| Ibrahim et al. [34] | 2008 | Retrospective case series | IV | 27.3 (17–45) | 20 | 53.0 (36–96) |
IIIM: 75% IIIL: 25% |
ACL/PCL reconstruction (autograft); collaterals reconstruction with LARS | Acute: 2–3 weeks |
97–80: 95% 78–79: 5% |
B 45.0% C 45.0% D 10.0% |
54 |
| Lo et al. [51] | 2009 | Prospective clinical trail | III | 33 (19–48) | 11 | 55.0 (36–78) | II–III | ACL/PCL reconstruction (autograft); MCL repair; PLC reconstruction (autograft) | Chronic: 76 days (30–150) | 88.0 ± 5.8 | A + B 82.0% | 70 |
| Engebretsen et al. [13] | 2009 | Prospective cohort study | III | 33 (12–82) | 85 | Minimum 24.0 (25.2–118.8) |
II: 6% IIIM: 49% IIIL: 32% IV: 10 12% |
ACL/PCL reconstruction (auto-/allograft, collaterals repair or reconstruction |
Acute 60%: 1–2 weeks Chronic 40%: > 2 weeks |
81.0 (42–100) | 64.0 ± 20.0 | 83 |
| Ranger et al. [69] | 2011 | Retrospective case series | IV | 38.5 | 71 | 24–96 |
II: 4% IIIL: 39% IIIM: 41% IV: 16% |
All structures repair and reconstruction with LARS (ligament augmentation and reconstruction system) | Acute: 10.8 days (± 8) | 78.5 ± 18.5 | 67.9 ± 19.9 | 55 |
| Ibrahim et al. [35] | 2013 | Retrospective case series | IV | 26.4 (18–48) | 20 | 44.0 (24–52) | IIIL | ACL/PCL reconstruction (autograft/LARS); PLC reconstruction (autograft) | Acute: 15–21 days |
95–80 90% 75–79 10% |
B 45.0% C 45.0% D 10.0% |
49 |
| Piontek et al. [68] | 2013 | Retrospective cohort study | III | 36.0 | 11 | 27.0 ± 4 |
II: 64% IIIM: 36% |
All structures reconstruction (autograft) | Chronic: > 6 months |
100–98 54.6% 97–93 45.4% |
A 36.4% B 54.6% C 9.0% |
66 |
| Werner et al. [87] | 2014 | Retrospective case series | IV | 35.0 | 65 | 144.0 |
IIIM: 49% IV: 51% |
ACL reconstruction; PCL reconstruction in 63%; medial: 25% conservative, 18% repair and 57% reconstruction | Acute: < 3 weeks |
KD IIIM: 88.0 KD IV: 67.0 |
n/a | 60 |
| Heitmannet al. [25] | 2014 | Prospective case series | III | 33.0 (18–60) | 8 | 11.8 (10–15) | III–IV | ACL/PCL repair and bracing; MCL repair | Acute: 5 days (4–7) | 85.3 (62–99) | 75.7 (52.9–94.3) | 65 |
| Richter et al. [70] | 2014 | Retrospective case series | IV | 28.0 (16–39) | 8 | 72 (24–134.4) | IIIM | ACL/PCL reconstruction (allograft); MCL reconstruction (allograft) |
25% acute 75% chronic |
81.0 (58–100) |
B 57.0% C 29.0% D 14.0% |
52 |
| Kohl et al. [46] | 2015 | Prospective case series | III | 33.4 (17–56) | 35 | 25.9 (12–42) |
III: 74.3% IV: 25.7% |
ACL repair and augmentation (dynamic intraligamentary stabilization); PCL repair; collaterals repair or combined reconstruction (autograft) | Acute: < 2 days | 90.8 (81–95) |
B 83.0% C 17.0% |
63 |
| Angelini et al. [1] | 2015 | Retrospective case series | IV | 29.3 | 14 | 49.4 |
IIIM 14% IIIL 64% IV 22% |
All ligaments reconstruction (allografts); hinged external fixateur for 6 weeks postoperative | Chronic: 2.5 months (0.5–3) | 81.5 (49–95) |
B 71.0% C 21.0% D 8.0% |
48 |
| Khakha et al. [43] | 2016 | Retrospective cohort study | III | 36.5 (19–65) | 36 | 121.2 (84–228) | II–IV | ACL/PCL reconstruction (auto-/allograft) with LARS; collaterals reconstruction or repair | Acute: 12 days (1–21) | 80.0 (57–91) |
A 3.0% B 56.0% C 36.0% D 8.0% |
55 |
| Huax et al. [30] | 2016 | Retrospective case series | IV | 38.8 | 16 | 57.6 ± 15.6 |
IIIM 17% IIIL 22% IV 50% V 11% |
All ligaments repair | Acute: 5–10 days | 87.5 ± 7.7 | n/a | 60 |
| Sundararajan et al. [80] | 2018 | Retrospective cohort study | IV | 39.0 (17–74) | 45 | 36.0 (24–72) |
IIIM 69% IIIL 31% |
ACL/PCL reconstruction (autograft); collaterals repair or reconstruction; MCL mostly conservative |
78% acute-subacute: < 6 weeks 11% subacute: (6–12 weeks) 11% chronic: (3 months-6 months) |
87.7 | 74.7 | 58 |
| Heitmann et al. [24] | 2019 | Prospective multicenter study | II | 34.2 (18–60) | 69 | 14.0 |
IIIM 35% IIIL 54% IV 12% |
ACL/PCL repair and bracing; collaterals repair | Acute: 7.3 ± 1.6 days | 81.0 ± 15.5 |
A 13.0% B 19.0% C 32.0% D 13.0% |
84 |
| Jokela et al. [41] | 2020 | Retrospective cohort study | III | prox: 39.0 (21–64) distal 49.0 (17–67) | 25 |
Prox/mid: 98 (40–145) distal: 66 (24–82) |
IIIM | ACL/PCL reconstruction; MCL (proximal/midsubstance) conservative; MCL (distal) repair/reconstruction | Acute: 19 days (5–38) |
prox/mid: 88 (57–99) distal: 75 (40–100) |
prox/mid: 80.0 (57–99) distal: 62.0 (39–87) |
62 |
| Rosteius et al. [75] | 2021 | Retrospective Cohort Study | III | 38.3 | 27 | 18.1 ± 12.1 |
IIIM 22% IIIL 33% IV 45% |
All ligaments repair and bracing | Acute | 81.5 ± 10.4 | n/a | 63 |
| Goyal et al. [19] | 2021 | Retrospective case series | IV | 33.5 | 27 | 24.0 |
II 30% IIIM 41% IIIL 22% IV 7% |
All ligaments reconstruction (autograft) | Chronic: 14.6 ± 5.9 weeks | 50.4 ± 11.7 | 62.8 ± 5.1 | 66 |
Age, follow-up, time to surgery and subjective scores (Lysholm, IKDC) are stated in mean ± standard deviation (range). Results of PROMS (Lysholm and IKDC Score) are stated in points (0–100) or are qualified as “normal” (A), “nearly normal” (B), “abnormal” (C) or “severely abnormal” (D). Acute surgery is defined as surgery within < 3 weeks after trauma
ACL Anterior cruciate ligament, PCL posterior cruciate ligament, MCL medial collateral ligament, LCL lateral collateral ligament, PLC posterolateral corner, prox proximal, athro arthroscopically assisted