The American journal of sports medicine · 2026 · 系統性回顧＋統合分析（依標題推測）
Lateral Extra-articular Procedures Reduce the Risk of Revision of Anterior Cruciate Ligament Reconstruction in Elite Athletes: A Systematic Review and Meta-analysis of Comparative Studies
膝 · 前十字韌帶損傷
中文閱讀摘要
系統性回顧與統合分析顯示，精英運動員ACLR加做LEAP，其再破裂率顯著低於單純ACLR，風險降低逾60%。
AI 依來源摘要整理，未經人工逐篇核對。閱讀結論前，請回溯研究族群、方法與限制。
原始摘要
Background
Lateral extra-articular procedures (LEAPs) have gained increasing attention as an adjunct to anterior cruciate ligament reconstruction (ACLR), particularly in individuals at high risk for reinjury. When combined with ACLR, LEAPs contribute to the restoration of normal knee kinematics and provide a significant reduction in residual anterior laxity compared with isolated ACLR. This added stability provides a protective effect on the intra-articular graft, promoting improved healing and integration while reducing mechanical stress on the reconstructed anterior cruciate ligament (ACL). As a result, these techniques have been demonstrated to result in improved performance after ACLR, higher graft survival, and lower revision rates, even in elite athletes who are at significant risk for reinjury.
Purpose/hypothesis
The aim of this study was to systematically compare the existing evidence on ACL rerupture rates by performing a meta-analysis comparing combined ACLR and LEAP versus isolated ACLR in elite athletes. The primary hypothesis of this systematic review and meta-analysis was that the addition of LEAP would reduce the rate of revision ACLR in elite athletes.
Study design
Systematic review and meta-analysis; Level of evidence, 3.
Methods
The method followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Embase, and Cochrane Library databases were searched to identify potentially relevant comparative studies that analyzed rerupture rate in elite athletes after isolated ACLR versus ACLR plus LEAP. The MINORS (Methodological Index for Non-Randomized Studies) score was used for quality assessment. The main outcome measure was ipsilateral ACL rerupture.
Results
A total of 586 elite athletes received an isolated ACLR, whereas 417 athletes received combined ACLR plus LEAP. Rerupture was reported by 9.3% (95% CI, 5.5%-14.0%) of athletes. In the ACLR group, 14.0% (95% CI, 7.9%-21.5%) reported a rerupture, whereas in the ACLR plus LEAP group, the reinjury rate was 5.0% (95% CI, 1.2%-10.8%), with a statistically significant difference between the 2 groups ( P = .042). Pooled odds ratio (OR) showed a 65% reduced risk of a new rupture episode in the ACLR plus LEAP group compared with the ACLR group, with an OR of 0.35 (95% CI, 0.20-0.59; P < .001).
Conclusion
In elite athletes, adding an anterolateral procedure during ACLR significantly reduced the rerupture rate and reduced the risk of rerupture by >60%. Despite the few studies considered, our study seems to indicate that surgeons should carefully consider LEAP when treating an elite athlete in order to significantly reduce the risk of rerupture.
Registration
PROSPERO: CRD42025637843.
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
- 10.1177/03635465251376655
- PMID／PMCID
- 41508654 / PMC12861538
- 作者
- D'Ambrosi R, Carrozzo A, Monaco E, Sconfienza LM, Herbst E, Herbort M, Abermann E, Fink C
- 首次發表日期
- 2026-01-08Europe 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
- 54 ／ 2 ／ 457-464
- 書目來源與查核日期
- 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。
- 全文與授權
- 來源列有免費全文（查核 2026-10-19），未逐篇測試 PDF 下載。 來源授權標示：cc by。
可回溯引用
D'Ambrosi R, Carrozzo A, Monaco E, Sconfienza LM, Herbst E, Herbort M, Abermann E, Fink C. Lateral Extra-articular Procedures Reduce the Risk of Revision of Anterior Cruciate Ligament Reconstruction in Elite Athletes: A Systematic Review and Meta-analysis of Comparative Studies. The American journal of sports medicine. 2026;54(2):457-464. PMID: 41508654. PMCID: PMC12861538. doi:10.1177/03635465251376655
本站供教育與研究參考。單篇摘要、文體標籤與期刊影響係數不等於證據品質或個別病人的診療建議。