EVALUATION OF THE EFFECTIVENESS OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION SURGERY: REVIEW OF CLINICAL STUDIES

Abstract

Anterior cruciate ligament (ACL) injury is common among athletes and physically active individuals, often resulting in joint instability and functional impairment. ACL reconstruction surgery is widely used to restore knee stability and allow functional recovery, but the effectiveness of the intervention varies according to the surgical technique and the type of graft used. This study aims to perform an integrative literature review to evaluate the effectiveness of ACL reconstruction surgery in terms of functional outcomes, return to sport rates, and postsurgical complications. A systematic search was performed in five electronic databases (PubMed, Cochrane Library, Web of Science, Scopus, and Embase) covering studies published between 2000 and 2023. Clinical studies that evaluated ACL reconstruction, with a minimum follow-up of one year, reporting functional outcomes, return to sport rates, and/or postsurgical complications were included. Study quality was assessed using the Jadad scale for randomized controlled trials and the Newcastle-Ottawa Scale for cohort and case-control studies. A total of 15 studies were included in the review. The selected studies varied in design and included a total of 3,472 patients. Most studies (n=12) reported significant improvements in postoperative functional scores, with autologous grafts, particularly flexor tendon grafts, providing better results. Return to sport rates ranged from 65% to 85%, and were higher in patients receiving autologous grafts. Postoperative complications, such as graft failure, joint stiffness, and development of early osteoarthritis, were less frequent with the use of autologous grafts and anatomical reconstruction techniques. The results of this integrative review highlight the effectiveness of ACL reconstruction surgery in improving functional outcomes and achieving a high rate of return to sport, especially with the use of autologous grafts and anatomical surgical techniques. Variability in study methods and outcome measures limits direct comparability, highlighting the need for standardization in future research. Assessment of study quality revealed that most studies presented good methodological quality, although some cohort and case-control studies demonstrated risks of bias. ACL reconstruction surgery is an effective intervention for restoring knee function, with better outcomes associated with the use of autologous grafts and anatomical reconstruction techniques. Continued research is essential to optimize treatment strategies and reduce postoperative complications, ensuring that patients receive the best possible care.