International journal of surgery (London, England) · 2026 · 系統性回顧＋統合分析（依標題推測）
Anterior cruciate ligament reconstruction in elite and professional athletes: does graft choice influence return to sport and failure rate? A systematic review and meta-analysis.
膝 · 前十字韌帶損傷
中文閱讀摘要
統合分析顯示，精英運動員ACL重建後重返運動率約82%，股二頭肌腱加LEAP組重返率顯著較高，但各移植物再破裂率無顯著差異。
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原始摘要
Background
Different grafts are used for anterior cruciate ligament (ACL) reconstruction, but their impact on return to sport (RTS) in elite and professional athletes remains unclear. Most evidence derives from nonprofessional cohorts, with limited data comparing graft-specific outcomes in high-demand populations.
Purpose
The purpose of the present systematic review and meta-analysis was to compare the return to play and percentage of re-rupture between different grafts in elite and professional athletes from different sports.
Study design
Systematic review and meta-analysis of level 3 and 4 studies.
Methods
A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines (PROSPERO Registry - CRD42025637410). MEDLINE, Embase, and the Cochrane Library were searched up to January 2025 for studies reporting RTS and re-rupture after primary ACL reconstruction in skeletally mature elite and professional athletes. Eligible designs included randomized controlled trials, cohort studies, case-control studies, and case series. Pooled proportions and odds ratios (ORs) were calculated using random- and mixed-effects models, with patellar tendon grafts as the reference group. Subgroup analyses were performed for concomitant meniscal injuries, multiligament injuries, and high-impact sports.
Results
Ten studies comprising 824 elite athletes were included. Overall, 81.7% (95% CI, 75.4-86.7) returned to sport, while the re-rupture rate was 7.1% (95% CI, 4.3-11.7). Use of hamstring/peroneus plus lateral extra-articular procedures (LEAPs) was associated with significantly higher RTS rates compared with the reference graft, both overall [94.0% (95% CI, 85.5-97.6); OR, 3.52; 95% CI, 1.20-10.34] and in high-impact sports [98.9% (95% CI, 94.2-100.0); OR, 23.16; 95% CI, 2.51-213.98]. No significant differences were observed between grafts in re-rupture rates (range 6.2-11.2%; all P > 0.05), although hamstring/peroneus plus LEAP showed a trend toward lower odds of re-rupture (OR, 0.32-0.45). Subgroup analyses of athletes with concomitant meniscal or multiligament injuries yielded similar findings, with no significant between-graft differences.
Conclusions
Approximately 80% of elite athletes RTS after ACL reconstruction, with an overall re-rupture rate of 7%. Hamstring/peroneus combined with a LEAP demonstrated superior RTS outcomes compared with other grafts, while re-rupture risk remained comparable. These findings suggest that while graft choice may influence RTS outcomes in elite athletes, the addition of a LEAP appears to further enhance RTS rates, particularly in high-demand sports.
至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19
書目、來源與全文狀態
- DOI
- 10.1097/js9.0000000000004837
- PMID／PMCID
- 41570285
- 作者
- D'Ambrosi R, D'Ambrosi R, Marchetti A, Farinelli L, Meena A, Albano D, Sconfienza LM, Gitto S, Herbst E, Kittl C, Herbort M, Abermann E, Fink C
- 首次發表日期
- 2026-01-23Europe PMC 提供，部分日期可能依年份或月份推定。
- 卷／期／頁碼或文章編號
- 卷未提供 ／ 期未提供 ／ 頁碼或文章編號未提供
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- Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
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- 來源尚未確認免費全文。 來源授權標示：cc by-sa。
可回溯引用
D'Ambrosi R, D'Ambrosi R, Marchetti A, Farinelli L, Meena A, Albano D, Sconfienza LM, Gitto S, Herbst E, Kittl C, Herbort M, Abermann E, Fink C. Anterior cruciate ligament reconstruction in elite and professional athletes: does graft choice influence return to sport and failure rate? A systematic review and meta-analysis. International journal of surgery (London, England). 2026. PMID: 41570285. doi:10.1097/js9.0000000000004837
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