Functional outcome of anterior cruciate ligament reconstruction with hamstring tendon autograft in Indian population: A systematic review and meta-analysis.

BACKGROUND: Anterior cruciate ligament (ACL) injury is a significant orthopedic issue globally with varying success rates among different populations. Better understanding of functional outcome can help design suitable protocols for ACL reconstruction and recovery. This review aims to evaluate the epidemiological trends and functional outcomes of ACLR procedures in India. METHODS: The review was conducted following PRISMA guidelines, by searching in Google Scholar, Pubmed, Web of Science and Science Direct databases in February 2024. The study encompassed patient demographics, and postoperative outcomes in Indian populations upon ACLR using hamstring tendon autografts. Meta-analysis was conducted with RevMan 5.4 using random-effects models. Funnel plots were used to explore publication bias. Subgroup analyses of follow-up terms and age were also performed. RESULTS: A total of 26 studies were pooled for overall qualitative and quantitative analysis. Sports injuries (52 %) were found to be more common, followed by road traffic accidents (31 %). Injuries were mostly on the right knees (56 %). Functional outcome analysis using Lysholm Knee Scoring Scale (MD 34.74, 95 % CI 31.58 to 37.89), International Knee Documentation Committee (MD 36.74, 95 % CI 32.36 to 41.13), Tegner Activity Scale (MD 0.90, 95 % CI -0.01 to 1.80) revealed statistically significant overall outcome effect. Statistically non-significant differences were found between follow-up to 6 months and follow-up above 6 months as well as with age. However, meta-analysis showed high level of heterogeneity. CONCLUSION: ACLR in Indian population is largely successful in restoring functional activity. However, the outcome of this review is limited by the heterogeneity factor. Further, the Indian studies have not focused on factors affecting the outcome. Therefore, future studies in this direction are needed for understanding the clinical success.