{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:02:56Z","timestamp":1789844576619,"version":"4.0.1"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":35,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe the safety, efficacy and clinical outcomes of suture\u2010augmented primary anterior cruciate ligament (ACL) repair with internal bracing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses guidelines; the protocol was registered in the PROSPERO database (registration number: CRD42024573962). A comprehensive search of the PubMed, Embase and Cochrane Library databases up to August 2024 was conducted to identify studies reporting clinical outcomes of suture\u2010augmented ACL repair. Inclusion criteria were a minimum follow\u2010up of 2 years, reporting of re\u2010rupture rates together with complications, or functional outcome scores such as International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm or Tegner activity scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen studies involving 671 patients met the eligibility criteria and were included. The ACL re\u2010rupture rate was 10.6% (95% confidence interval [CI]: 7.4\u201314.2), and the rate of reoperations unrelated to ACL re\u2010rupture (primarily for hardware removal) was 3.2% (95% CI: 0.9\u20136.5). The pooled data showed a mean time to reinjury of 1.2 years (95% CI: 1\u20131.3), and failure occurred at a mean patient age of 19.8 years (95% CI: 14.8\u201324.8). The mean return to sport was 9.5 months (95% CI: 5.7\u201313.3). Patient\u2010reported outcome measures included IKDC with a post\u2010operative mean score of 86.9 (95% CI: 83.6\u201390.1) and KOOS total score of 85 (95% CI: 82.1\u201388). KT\u20101000 laxity measurements revealed a mean side\u2010to\u2010side difference of 0.9\u2009mm (95% CI: 0.5\u20131.3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Suture\u2010augmented primary ACL repair with internal brace shows acceptable clinical results, encouraging functional recovery and re\u2010rupture rates. Internal bracing is not associated with a high rate of complications, suggesting that the technique is safe and appropriate for use in carefully selected patients. However, heterogeneity in the existing studies means that additional high\u2010quality, long\u2010term comparative studies are needed to clarify the indications and reliability of this procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, systematic review of studies with LoE I\u2013IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70495","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T16:31:14Z","timestamp":1762360274000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Suture\u2010augmented primary anterior cruciate ligament\u00a0repair with internal brace shows acceptable re\u2010rupture rates, favourable outcomes\u00a0and high return\u2010to\u2010sport rates: A systematic review"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0700-8139","authenticated-orcid":false,"given":"Alessandro","family":"Carrozzo","sequence":"first","affiliation":[{"name":"Dipartimento di Scienze della Vita, della Salute e delle Professioni Sanitarie Universit\u00e0 degli Studi \u201cLink Campus University\u201d Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9milie","family":"B\u00e9rard","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Public Health CERPOP, INSERM\u2010University of Toulouse III, Toulouse University Hospital (CHU) Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Nasso","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology, AOU Sant\u2032Andrea La Sapienza University of Rome Rome 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