SynthesisSports medicine (Auckland, N.Z.)2023
Return to Sports: A Risky Business? A Systematic Review with Meta-Analysis of Risk Factors for Graft Rupture Following ACL Reconstruction.
Synthesis in Sports medicine (Auckland, N.Z.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 3 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Hop Test Performance is Associated with Return-to-Sport but Shows Limited Association with Reinjury after Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis.Journal of sports science & medicine · 2026Pooled it
- The utility of psychological readiness scales in predicting return to sport: a systematic review.BMC psychology · 2025Pooled it
- Cartilage tissue healing and regeneration based on biocompatible materials: a systematic review and bibliometric analysis from 1993 to 2022.Frontiers in pharmacology · 2023Pooled it
- Trial
- Double-bundle anterior cruciate ligament reconstruction resulted in better International Knee Documentation Committee objective grading at fifteen year follow-up compared to single-bundle reconstruction.International orthopaedics · 2024Trial
- Proximal anatomical axes show bidirectional variability: Accurate tibial slope requires mechanical axis measurement.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Postoperative Quadriceps Symmetry, Knee Laxity, and Single-Leg Hop Performance in Association with 24-Month Ipsilateral Graft Retear After Anterior Cruciate Ligament Reconstruction: A Cohort Study.Life (Basel, Switzerland) · 2026Article
- Patient-Reported Knee Function Versus Star Excursion Balance Performance as Correlates of Psychological Return-to-Sport Readiness After Anterior Cruciate Ligament Reconstruction.Bioengineering (Basel, Switzerland) · 2026Article
- Graft-to-Footprint Mismatch Is Not Associated with Early ACL Reconstruction Failure: A Retrospective Cohort Study.Sports (Basel, Switzerland) · 2026Article
- The 3D Biomechanics of Secondary Non-contact ACL Injuries in Two Female Adolescents: A Case Series of an Ipsilateral ACL Re-Rupture and a Contralateral ACL Rupture.Sports medicine (Auckland, N.Z.) · 2026Article
- The impact of on-field rehabilitation on return to play and ACL re-injury risk after ACL reconstruction in football (soccer) players: A study on 401 consecutive cases.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Generalised joint hypermobility and excess knee hyperextension are associated with an increased risk for second ACL injury, but not primary ACL injury, in female football players: A 5-year follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Visual processing and interference performance influences on knee angular impulse in ACLR individuals: a cognitive-biomechanical analysis of drop-jumps.Archives of orthopaedic and trauma surgery · 2026Article
- Anterior cruciate ligament reconstruction in the modern era: A patient-centered approach.World journal of clinical cases · 2025Article
- Review
- High return to sports and favorable long-term clinical outcomes in professional elite skiers following anterior cruciate ligament reconstruction utilizing hamstring tendon autografts.BMC musculoskeletal disorders · 2025Article
- Graft remodelling of hamstring ACL graft and secondary meniscal lesions are affected by tibial slope and body mass index.Journal of experimental orthopaedics · 2025Article
- Quadriceps Strength and Hamstring-to-Quadriceps Ratios in Pediatric Patients After ACL Reconstruction: Revisiting Norms from Adult Data.Orthopaedic journal of sports medicine · 2025Article
- Young age and return to play increase the likelihood of subsequent ACL reconstruction in football players: Data from the Swedish National Knee Ligament Registry.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Early versus standard return to play following ACL reconstruction: impact on volume of play and career longevity in 180 professional European soccer players: a retrospective cohort study.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe risk of sustaining a graft rupture after anterior cruciate ligament reconstruction (ACLR) is high. Contributing risk factors are, however, still not clearly identified.
objectiveThe aim of this systematic review was to identify and quantify risk factors for graft rupture after ACLR.
methodsA systematic review with meta-analysis (PROSPERO CRD42020140129) based on PRISMA guidelines was performed. MEDLINE, CINAHL and EMBASE were searched from inception to September 2021. Prospective and retrospective studies addressing risk factors for graft rupture after ACLR in males/females of all ages were considered. Meta-analyses using a random effect model (effect measure: odds ratio [OR] with 95% confidence interval [CI]) were performed. The GRADE tool was used to assess evidence quality.
resultsFollowing full-text screening of 310 relevant papers, 117 were eventually included, incorporating up to 133,000 individuals in each meta-analysis. Higher Tegner activity level (≥ 7 vs < 7) at primary injury (OR 3.91, 95% CI 1.69-9.04), increased tibial slope (degrees) (OR 2.21, 95% CI 1.26-3.86), lower psychological readiness to return to sport (RTS) (OR 2.18, 95% CI 1.32-3.61), early surgery (< 12 vs ≥ 12 months) (OR 1.87, 95% CI 1.58-2.22), RTS (pre-injury level) (OR 1.87, 95% CI 1.21-2.91) and family history of ACL injury (OR 1.76, 95% CI 1.34-2.31) were all associated with increased odds of graft rupture. Higher age (OR 0.47, 95% CI 0.39-0.59), female sex (OR 0.88, 95% CI 0.79-0.98), fewer self-reported knee symptoms pre-reconstruction (OR 0.81, 95% CI 0.69-0.95) and concomitant cartilage injuries (OR 0.70, 95% CI 0.62-0.79) instead decreased the odds. Meta-analysis revealed no association between body mass index, smoking, joint laxity, RTS time, knee kinematics, muscle strength or hop performance and graft rupture.
conclusionConspicuous risk factors for graft rupture were mainly sports and hereditary related. Few studies investigated function-related modifiable factors or included sports exposure data.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.