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Meta-analysis finds similar outcomes in ACL reconstruction with bioabsorbable vs. metallic interference screws
Shen C. Arthroscopy. 2010;26(5):705-713.
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A Level I study comparing the use of bioabsorbable and metallic interference screws in anterior cruciate ligament reconstruction found no significant difference in knee joint stability or knee joint function.
Chao Shen, MD, MSc, and colleagues conducted a meta-analysis of 790 patients from 10 randomized controlled trials (RCTs). They analyzed outcomes in terms of infection, knee joint effusion, Lysholm score, International Knee Documentation Committee (IKDC) final score, pivot-shift test, and KT-1000/-2000 arthrometer (MEDmetric) measurements.
The investigators used a fixed-effects or random-effects model to calculate standard mean difference or risk ratio with 95% confidence interval. Heterogeneity across the studies was also assessed.
Their results showed no significant differences between bioabsorbable and metallic screw fixation in infection rate, KT-1000/-2000 arthrometer testing, pivot-shift testing, IKDC final score, and Lysholm score.
The authors noted that the incidence of knee effusion was higher with bioabsorbable interference screw fixation than with metallic interference screw fixation and called for more high-methodologic quality randomized controlled trials for further meta-analysis.