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

PurposeThe 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.MethodsA 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.ResultsTwenty-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.ConclusionsGraft 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 evidenceLevel IV, systematic review of level I–IV investigations.

• Publication year

  2019

• Venue

  Knee Surgery and Related Research

• Publication date

  2019-06-28

• Fields of study

  Medicine, Engineering

• Identifiers
  DOI 10.1186/s43019-019-0005-3PMID 32660558PMCID 7219533
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Preservation of remnant with poor synovial coverage has no beneficial effect over remnant sacrifice in anterior cruciate ligament reconstruction

  2018influential reference
• Clinical and arthroscopic outcome of single bundle anterior cruciate ligament reconstruction: Comparison of remnant preservation versus conventional technique.

  2017cited by this paper
• Clinical outcomes and biomechanical analysis of posterolateral bundle augmentation in patients with partial anterior cruciate ligament tears

  2017cited by this paper
• Hamstring autograft maturation is superior to tibialis allograft following anatomic single-bundle anterior cruciate ligament reconstruction

  2017influential reference
• Double-bundle anterior cruciate ligament reconstruction with and without remnant preservation - Comparison of early postoperative outcomes and complications.

  2017cited by this paper
• Second-Look Arthroscopic Evaluation and Clinical Outcomes of Anatomic Anterior Cruciate Ligament Reconstruction with Autograft and Hybrid Graft: A Retrospective Study

  2017cited by this paper
• Comparison of clinical outcomes and second-look arthroscopic findings after ACL reconstruction using a hamstring autograft or a tibialis allograft

  2016cited by this paper
• Effects of Remnant Tissue Preservation on Clinical and Arthroscopic Results After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

  2015cited by this paper
• Anatomic Placement of the Femoral Tunnels in Double-Bundle Anterior Cruciate Ligament Reconstruction Correlates With Improved Graft Maturation and Clinical Outcomes.

  2015cited by this paper
• Placement of Double Tunnels in ACL Reconstruction Using Bony Landmarks Versus Existing Footprint Remnant

  2015cited by this paper
• Autograft Versus Allograft Anterior Cruciate Ligament Reconstruction

  2015cited by this paper
• The Impact of the Multicenter Orthopaedic Outcomes Network (MOON) Research on Anterior Cruciate Ligament Reconstruction and Orthopaedic Practice

  2015cited by this paper
• Clinical outcomes of second-look arthroscopic evaluation after anterior cruciate ligament augmentation: comparison with single- and double-bundle reconstruction.

  2014cited by this paper
• Hamstring autograft versus soft-tissue allograft in anterior cruciate ligament reconstruction: a systematic review and meta-analysis of randomized controlled trials.

  2014cited by this paper
• Comparison of second-look arthroscopic findings and clinical results according to the amount of preserved remnant in anterior cruciate ligament reconstruction.

  2014cited by this paper
• Clinical and Second-Look Arthroscopic Study Comparing 2 Tibial Landmarks for Tunnel Insertions During Double-Bundle ACL Reconstruction With a Minimum 2-Year Follow-up

  2012cited by this paper
• Arthroscopic evaluation of preserved ligament remnant after selective anteromedial or posterolateral bundle anterior cruciate ligament reconstruction.

  2012cited by this paper
• Introducing levels of evidence to the journal

  2011cited by this paper
• Triple-bundle ACL grafts evaluated by second-look arthroscopy

  2011cited by this paper
• Effect of patient age on morphology of anterior cruciate ligament grafts at second-look arthroscopy.

  2011cited by this paper
• Anterior cruciate ligament reconstruction using remnant preservation and a femoral tensioning technique: clinical and magnetic resonance imaging results.

  2011cited by this paper
• Outcomes and second-look arthroscopic evaluation after double-bundle anterior cruciate ligament reconstruction with use of a single tibial tunnel.

  2011cited by this paper
• A Second Look

  2011cited by this paper
• Comparison of clinical results and second-look arthroscopy findings after arthroscopic anterior cruciate ligament reconstruction using 3 different types of grafts.

  2010cited by this paper
• Anatomic double-bundle anterior cruciate ligament reconstruction using hamstring tendons with minimally required initial tension.

  2010cited by this paper
• Ligamentization of tendon grafts treated with an endogenous preparation rich in growth factors: gross morphology and histology.

  2010cited by this paper
• Second-look arthroscopic evaluations of anatomic double-bundle anterior cruciate ligament reconstruction: relation with postoperative knee stability.

  2007cited by this paper
• Femoral bioabsorbable cross-pin fixation in anterior cruciate ligament reconstruction.

  2007cited by this paper
• Arthroscopic evaluation of ACL grafts reconstructed with the anatomical two-bundle technique using hamstring tendon autograft

  2007cited by this paper
• Second-look arthroscopic findings of 208 patients after ACL reconstruction

  2007cited by this paper
• Effects of reinforcement with the iliotibial tract flap in ACL reconstruction using bone-patellar tendon-bone

  2005cited by this paper
• Second-look arthroscopy of anterior cruciate ligament grafts with multistranded hamstring tendons.

  2004cited by this paper
• Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies

  2000cited by this paper
• Revascularization and ligamentization of autogenous anterior cruciate ligament grafts in humans.

  1998cited by this paper
• Arthroscopic second look findings of an anterior cruciate ligament bone-patellar tendon-bone autograft.

  1997cited by this paper
• Freeze-dried fascia lata allografts in the reconstruction of anterior cruciate ligament defects. A two- to seven-year follow-up study.

  1994cited by this paper
• Arthroscopic and histologic analysis of human patellar tendon autografts used for anterior cruciate ligament reconstruction

  1993cited by this paper
• The phenomenon of “Ligamentization”: Anterior cruciate ligament reconstruction with autogenous patellar tendon

  1986cited by this paper

• Radiologic maturation and tunnel changes after all-inside versus standard hamstring ACL reconstruction: a prospective comparative study.

  2026cites this paper
• Comparative assessment of graft maturity after anterior cruciate ligament reconstruction using different graft types: a systematic review

  2026cites this paper
• Second Look Arthroscopy following Anterior Cruciate Ligament Reconstruction is Unable to Detect Structural Causes of Worsened Patient Reported Outcome Measures.

  2025cites this paper
• Lower patient reported outcomes after isolated anterior cruciate ligament reconstruction are associated with lower muscle strength rather than graft status during second-look arthroscopic evaluation.

  2025cites this paper
• Superior Biological Healing of Hamstring Autografts Compared with Tibialis Allografts after Anterior Cruciate Ligament Reconstruction: A Propensity Score Matching Analysis Based on Second-Look Arthroscopy

  2024cites this paper
• Meniscal resection increases the risk of residual knee laxity even in patients undergoing anatomic double-bundle anterior cruciate ligament reconstruction with eight strands of hamstring autografts

  2022cites this paper
• Adjustable-Loop Cortical Suspensory Fixation Results in Greater Tibial Tunnel Widening Compared to Interference Screw Fixation in Primary Anterior Cruciate Ligament Reconstruction

  2022cites this paper
• Comparison of ligamentization potential between anterior cruciate ligament-derived cells and adipose-derived mesenchymal stem cells reseeded to acellularized tendon allograft

  2022cites this paper
• Bone-patellar tendon–bone autograft maturation is superior to double-bundle hamstring tendon autograft maturation following anatomical anterior cruciate ligament reconstruction

  2021cites this paper
• Effect of Muscle Cell Preservation on Viability and Differentiation of Hamstring Tendon Graft In Vitro

  2021cites this paper
• Mesenchymal stromal cells and platelet-rich plasma promote tendon allograft healing in ovine anterior cruciate ligament reconstruction

  2020cites this paper