Orthopaedic journal of sports medicine · 2026 · 系統性回顧＋統合分析（依標題推測）
Reconstruction After an Anterior Cruciate Ligament Injury Does Not Reduce the Osteoarthritis Risk But Lowers the Total Knee Arthroplasty Rate: A Systematic Review and Meta-analysis
膝 · 全膝關節置換術
中文閱讀摘要
系統性回顧與統合分析顯示，ACL重建未降低放射學性OA風險，但顯著降低全膝關節置換率。
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原始摘要
Background
An anterior cruciate ligament (ACL) rupture is a common and debilitating knee injury. Although surgical management restores knee stability, its effectiveness in preventing long-term joint degeneration compared with nonoperative management remains unclear.
Purpose/hypothesis
The purpose of this study was to compare the long-term incidence of radiographic knee osteoarthritis (OA) after the operative versus nonoperative management of ACL injuries. It was hypothesized that operative management would lead to lower rates of OA.
Study design
Systematic review and meta-analysis; Level of evidence, 3.
Methods
A systematic review and meta-analysis were conducted per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, Embase, and Scopus were searched through June 2025 for comparative studies evaluating the development of OA after an ACL injury that was treated with operative or nonoperative management. Radiographic OA was defined as Kellgren-Lawrence grade ≥2 or equivalent. Random-effects meta-analyses were performed to compare radiographic OA, secondary meniscal surgery, and total knee arthroplasty (TKA) rates between treatment groups. Study quality was assessed using the MINORS (Methodological Index for Non-Randomized Studies) instrument and the Cochrane RoB 2 (risk of bias tool). The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework.
Results
A total of 18 studies comprising 33,540 patients (mean follow-up, 12.3 years) were included. A meta-analysis of 15 studies found no significant difference in radiographic OA between the ACL reconstruction (ACLR) and nonoperative groups (risk ratio [RR], 1.01 [95% CI, 0.79-1.27]; I 2 = 92%; P = .96). A sensitivity analysis of level 1 to 2 studies with low heterogeneity yielded similar findings (RR, 1.14 [95% CI, 0.87-1.48]; I 2 = 34%; P = .33). A meta-analysis of 2 studies assessing OA prevalence in the ACL repair versus nonoperative group also found no statistically significant difference, with moderate heterogeneity (RR, 0.78 [95% CI, 0.54-1.12]; I 2 = 55%; P = .18). Rates of secondary meniscal surgery did not differ significantly (RR, 0.79 [95% CI, 0.52-1.21]; I 2 = 56%; P = .29). However, ACLR significantly reduced the risk of TKA (RR, 0.17 [95% CI, 0.07-0.43]; I 2 = 59%; P = < .001).
Conclusion
The operative management of ACL injuries did not decrease the long-term risk of developing radiographic OA compared with nonoperative management. ACLR was associated with a lower rate of TKA.
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
- 10.1177/23259671261451241
- PMID／PMCID
- 42539917 / PMC13424783
- 作者
- Blackman B, Juric M, Ybema S, Bouchard MD, Macciacchera M, Matache BA, Abouali J
- 首次發表日期
- 2026-07-30Europe 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
- 14 ／ 7 ／ 23259671261451241
- 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
Blackman B, Juric M, Ybema S, Bouchard MD, Macciacchera M, Matache BA, Abouali J. Reconstruction After an Anterior Cruciate Ligament Injury Does Not Reduce the Osteoarthritis Risk But Lowers the Total Knee Arthroplasty Rate: A Systematic Review and Meta-analysis. Orthopaedic journal of sports medicine. 2026;14(7):23259671261451241. PMID: 42539917. PMCID: PMC13424783. doi:10.1177/23259671261451241
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