Abstract
Objectives:
Over recent years, there has been growing interest in utilizing surgical sutures and Fibertape as internal braces or augmentations during anterior cruciate ligament (ACL) reconstruction procedures. This systematic review aims to critically evaluate the comparative effectiveness of surgical sutures versus Fibertape in ACL reconstruction as internal braces or augmentations.
Methods:
We conducted a systematic review and meta-analysis to compare the biomechanical properties of surgical sutures and Fibertape in ACL surgery. A comprehensive search was conducted across PubMed/MEDLINE, SCOPUS, and Europe PMC for studies published up to July 4th, 2024. The systematic review was structured around the PICO framework, focusing on patients who had undergone ACL reconstruction surgery (P), comparing the use of surgical sutures (I) versus Fibertape (C), and evaluating outcomes related to elasticity, strength, and graft stability (O). Only peer-reviewed papers published in English were included. Meta-analysis was performed using RStudio. Quality assessment of the included studies was conducted using the JBI checklist.
Results:
We included a total of 14 studies involving in vivo ACL reconstructions. ACL reconstruction with an Fibertape demonstrated significantly greater strength (standard mean difference [SMD]: 2.47, 95% CI: 1.26 to 3.68; p < 0.01) and decreases elasticity (SMD: 2.22, 95% CI: 0.93 to 3.51; p < 0.001) compared to traditional surgical sutures, but not strength of the construct (SMD: 0.43, 95% CI: -0.11 to 0.97; p = 0.42). EAll included studies were of lower risk of bias.
Conclusion:
We suggest that ACL reconstruction using Fibertape provides significantly enhanced strength and stiffness compared to surgical sutures. Given the lower risk of bias across all included studies, adopting Fibertape in ACL surgeries may offer improved biomechanical outcomes.