Table 2.
Data Extraction Table
| Author, year |
||
|---|---|---|
| Li 201625 | Wang 200426 | |
| Country | China | Taiwan |
| Interventions/Products | 4-stranded y-irradiated tibialis anterior tendon allograft | Allograft (incl. Achilles tendon and anterior tibial tendons) |
| Comparator | Gracilis and semitendinosus tendon autograft Hybrid graft (y-irradiated tibialis anterior tendon allograft and semitendinosus tendon autograft) |
Autograft (incl. quadriceps tendon-patellar bones and quadruple hamstrings) |
| Surgical procedure | Arthroscopic single-bundle PCLR | Arthroscopic single-bundle PCLR |
| Study design | RCT | RCT |
| Number of patients | 90∗ 30 vs 30 vs 30 |
55 23 vs 32 |
| Inclusion criteria | Persistent posterior laxity greater than or equal to grade 2, Lack of response to conservative treatment (medication and physical therapy) for more than 3 months Objective evidence of PCL rupture by MRI. |
NR† |
| Exclusion criteria | Concomitant injury to other knee ligaments, previous surgery on the injured knee, or articular cartilage lesions greater than Outerbridge grade II based on the preoperative MRI scan and diagnostic arthroscopic examination | Patients with PCL avulsion fracture and combined ligament injuries were not included. |
| Rehabilitation (before or after PCLR) | The 3 groups of patients followed the same postoperative rehabilitation program. Physiotherapy‡ Rehabilitation outside the hospital was not controlled. |
Patients received the same postoperative rehabilitation (incl., e.g., exercise, functional knee braces, etc.). Physiotherapy: NR |
| Age of patients, mean ± SD (range), yrs | 32.2 ± 7.8 (20-40) vs 31.3 ± 6.2 (20-40) vs 30.6 ± 7.5 (20-40)§ | 30 ±12 (16-64) vs 29 ±12 (16-54) |
| Sex, n female (%) | 11 (40.7) vs 9 (34.6) vs 10 (37)§ | 7 (30.4) vs 7 (21.9) |
| Further relevant patient characteristics | Patients with meniscal tears underwent partial meniscectomies (if irreparable) or repairs. No. of patients with no treatment of meniscal tears: 10/30 patients (33.3%) vs 9/30 patients (30%) vs 9/30 patients (30%); diff. n. s. |
Associated injuries were treated accordingly before PCLR. Concomitant treatments‖: 5 meniscectomies 3 meniscal repairs 3 debridements for chondral lesions |
| Mean follow-up in yrs ± SD | Overall¶: 5.6 5.7 ± 0.3 vs 5.5 ± 0.2 vs 5.6 ± 0.5 |
Overall#: 2.83 2.83 vs 2.75 |
| Loss to follow-up, n (%) | Overall: 10 (11) 3 (10) vs 4 (13.33) vs 3 (10) |
NR∗∗ |
| Patients included in analysis, n | 27 vs 26 vs 27 | 23 vs 32 |
| Effectiveness Outcomes | ||
| Patient-reported function, activity levels and symptoms | ||
| Lysholm score, mean ± SD (range) | Preoperative: 64.1 ± 10.8 vs 63.8 ± 11.2 vs 62.3 ± 12.9; diff. n. s. with P = 0.721 Postoperative††: 85.2 ± 3.9 vs 87.8 ± 3.6 vs 86.9 ± 4.3; diff. n. s., with P = 0.193 |
Preoperative: NR Postoperative‡‡ 92.3 ± 6.8 vs. 87.8 ± 9.6; diff. n. s., with P = 0.077 |
| Tegner score, mean ± SD | Preoperative: 2.6 ± 1.1 vs 2.7 ± 1.2 vs 2.9 ± 1.3; diff. n. s., with P = 0.662 Postoperative†† 6.2 ± 1.7 vs 6.8 ± 1.1 vs 6.5 ± 1.8; diff. n. s., with P = 0.096 |
4.70 ± 1.66 vs 4.73 ± 1.66; diff. n.s., with P = 0.976 |
| IKDC score (subjective) , mean ± SD (range) | Preoperative: 65.9 ± 9.3 vs 66.5 ± 10.1 vs 65.5 ± 11.5; diff. n. s., with P = 0.586 Postoperative†† 80.2 ± 6.8 vs 83.5 ± 6.3 vs 82.8 ± 5.7; diff. n. s., with P = 0.153 |
NR |
| Clinical knee stability | ||
| Lachman test (grade 0-1), n (%) | NR | Reverse Lachman Preoperative: NR Postoperative‡‡: mean ± SD (range)§§: 0.70 ± 0.56 (0-2) vs 0.75 ± 0.67 (0-3); diff. n. s., with P = 0.898 |
| Pivot shift test (grade 0-1), n (%) | Reverse Pivot shift (postoperative at final FU): 26 (96.3) vs 26 (100) vs 27 (100); diff. n. s., with P = 0.407 |
NR |
| Side-to-side difference in mm, mean ± SD (range) | Measured with Instrumented Anteroposterior Measurements Postoperative: 3.5 ± 1.1 (NR‖‖) vs 2.1 ± 1.0 (NR¶¶) vs 2.6 ± 1.2 (NR##); diff. s. s., with P < 0.001 |
Measured with the KT-1000 arthrometer Preoperative: NR Postoperative∗∗∗: 2.83 ± 1.70 (1-6) vs 3.16 ± 2.60 (1-10); diff. n. s., with P = 0.605 |
| IKDC score (objective; normal and nearly normal), n (%)††† | Postoperative (at Final FU): 24 (88.9) vs 25 (96.2) vs 25 (92.6); diff. n. s., with P = 0.716 |
Preoperative: NR Postoperative‡‡‡: 14 (60.9) vs 23 (71.9); diff. n. s., with P = 0.391 |
| Safety Outcomes | ||
| Reoperation rate, n (%) | The study stated that no patient needed additional surgery because of recurrent or residual posterior laxity. | NR |
| Overall complications, n (%) | NR | 0 (0) vs 7 (21.9) |
| Infection, n (%) | The study stated that no postoperative infection occurred. | 0 (0) vs 2 (6.3)§§§ |
| Other complications | Regarding complications, the study reported that there were no cases of major neurovascular, infectious, vascular, deep venous thrombosis, or wound complications. | Donor site pain: 0 (0) vs 4 (12.5) Reflex sympathetic dystrophy (RSD): 0 (0) vs 1 (3.1) Tibial and femoral tunnel Enlargement was comparable between the allograft and autograft groups with no significant difference at final follow-up: Tibial‡‡‡: 12 ± 20 (range: 0-90) vs 12 ± 14 (range: 0-43), with P = 0.64 Femoral‡‡‡: 5.3 ±22 (range: 0-50) vs 13 ±19 (range: 0-55), with P = 0.771 |
116 points were assessed for eligibility. Of those, 90 points were randomized in the 3 treatment groups.
The study reported only that it consisted of patients who underwent PCL reconstruction. In this context, the study states that the indication for surgery included pain and instability because of high-energy posterior cruciate ligament injury with failure of conservative treatments for 3 months.
Postoperative physiotherapy may have included, but was not limited to, the following: a functional brace (6-12 weeks), passive range of motion exercises, progressive weight bearing after 2 weeks, and closed kinetic chain exercises.
The study reported on demographic data using the analyzed (not the enrolled) patients. Therefore, the denominator(s) are the analyzed patients within the groups.
Differences between treatment groups were not reported.
The overall mean was calculated by the review authors based on the mean FU time of the respective treatment groups.
The study only reported on the FU time in months. Overall: 34±10 (34 ±11 vs. 33 ±12)
The study did not adequately report on the enrolment process. Therefore, the loss to follow-up rate could not have been calculated.
There were significant differences (p<0.05) between baseline scores and the last follow-up scores after surgery.
The time point was not clearly reported.
The study reported only on the mean and range of the Lachman test.
95%CI was reported: 3.083-3.9200.
95%CI was reported: 1.6946-2.4941.
95%CI was reported: 2.1028-3.0397.
The time point was not clearly reported.
The overall IKDC score has 4 qualitative characteristics regarding knee functionality: normal, nearly normal, abnormal, and severely abnormal. In this assessment, only the number of patients with normal and nearly normal characteristics were extracted and summed up.
Femoral and tibia tunnel enlargements are presented in percentage of the tunnel width at follow-up over the width postoperative in AP view X-ray.
Excluding patients with hybrid grafts. The number of patients refers to the analysed patients, not the enrolled ones.