Anterior cruciate ligament reconstruction: a systematic literature review

Abstract

Introduction Anterior cruciate ligament (ACL) injury is common in high-intensity sports and impacts knee stability. ACL reconstruction is the standard intervention to restore function and prevent complications such as osteoarthritis. The type of graft and surgical technique influence clinical outcomes and patient recovery. Methodology This systematic review followed PRISMA guidelines, analyzing studies published between 2014 and 2024 from databases such as PubMed and Medline. Clinical trials, observational studies, and case studies with full texts in English were included. Exclusion criteria included secondary studies and works in languages other than English. Results Autologous grafts, such as hamstring and patellar tendons, are effective for functional stability, while allografts present a higher risk of complications. Associated injuries, such as meniscal and cartilage damage, influence recovery and can lead to early osteoarthritis. Innovative techniques, including the use of stem cells and PRP, have shown potential but require further evidence. Postoperative pain management and psychological support directly impact rehabilitation and functional outcomes. Conclusion ACL reconstruction should be personalized, considering age, level of physical activity, and associated injuries. Autologous grafts remain the best options, but advances such as stump preservation and adjunctive therapies may optimize healing and function. Long-term multicenter studies are needed to validate these practices.