Knee Surg Relat Res.  2019 Sep;31(3):e2. 10.1186/s43019-019-0005-3.

Evaluation parameters of graft maturation on second-look arthroscopy following anterior cruciate ligament reconstruction: a systematic review

Affiliations
  • 1Department of Orthopaedic Surgery, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea. osman@korea.ac.kr
  • 2Department of Rheumatology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.

Abstract

PURPOSE
The purpose of this systematic review was to investigate and summarize the evaluation methods of graft maturation on second-look arthroscopy following anterior cruciate ligament (ACL) reconstruction.
METHODS
A literature search was performed on articles before December 2017 to identify the literature that has evaluated graft maturation on second-look arthroscopy following ACL reconstruction. Only studies using human grafts, evaluating graft maturation with two or more gross findings were included. Study design, grafts, surgical techniques, follow-up period, evaluation parameters, and categories were compiled.
RESULTS
Twenty-eight studies were included in this study. All studies evaluated graft maturation with two or more of the following three findings: graft integrity, tension, and synovial coverage. Two to four categories were used for evaluating each parameter, but the criteria for classification were slightly different for each study. Several studies reported neo-vascularization of grafts and the total maturation score by summing up the scores assigned to each evaluation parameter. Three studies reported that there was no correlation between second-look findings and patient-reported outcomes.
CONCLUSIONS
Graft integrity, tension, and synovial coverage were the most frequently evaluated for graft maturation on second-look arthroscopy. However, there is no uniform criterion for evaluation. Therefore, development of a valid, uinform criterion is required. LEVEL OF EVIDENCE: Level IV, systematic review of level I-IV investigations.

Keyword

Knee; Anterior cruciate ligament reconstruction; Second-look surgery; Graft; Maturation; Systematic review

MeSH Terms

Anterior Cruciate Ligament Reconstruction*
Anterior Cruciate Ligament*
Arthroscopy*
Classification
Clothing
Follow-Up Studies
Humans
Knee
Second-Look Surgery
Transplants*
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