ACL Reconstruction with Augmentation: a Scoping Review

  • Michael D. Riediger
  • Devon Stride
  • Sarah E. Coke
  • Adrian Z. Kurz
  • Andrew Duong
  • Olufemi R. AyeniEmail author
Outcomes Research in Orthopedics (O Ayeni, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Outcomes Research in Orthopedics


Purpose of Review

We reviewed the recent literature to identify and summarize new research surrounding anterior cruciate ligament reconstruction (ACLR) with augmentation in the form of additional soft tissue procedures or biologic augmentation. Specifically, we wanted to review the failure rates of these procedures in both the primary and revision settings.


The databases Embase, PubMed, and Medline were searched on August 13, 2018, for English-language studies that reported on the use of anterior cruciate ligament reconstruction (primary and revision) in conjunction with either soft tissue or biologic augmentation. The studies were systematically screened and data abstracted in duplicates.

Recent Findings

Advancements in ACLR surgery, including soft tissue augmentation, may decrease primary and revision surgery failure rates for high-risk patients. The use of biological augmentation has shown histologic and radiographic improvements. These differences, however, have failed to be statistically significant and have not resulted in clinically significant improvements in outcome.


The limited body of evidence has shown that the addition of soft tissue procedures may in fact lower the risk of graft re-rupture rates particularly in revision or in patients wishing to return to high-risk sports and activities. The use of biologic augmentation although promising in laboratory studies has yet to show any significant clinical results and therefore will require further studies to prove any efficacy.


Anterior cruciate ligament Anterolateral ligament Lateral tenodesis Platelet-rich plasma Lemaire 


Compliance with Ethical Standards

Conflict of Interest

Michael D. Riediger, Devon Stride, Sarah E. Coke, Adrian Z. Kurz, and Andrew Duong each declare no potential conflicts of interest.

Olufemi R. Ayeni is on the speaker’s bureau for Conmed and Smith & Nephew and is a section editor for Current Reviews in Musculoskeletal Medicine.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Michael D. Riediger
    • 1
  • Devon Stride
    • 1
  • Sarah E. Coke
    • 2
  • Adrian Z. Kurz
    • 1
  • Andrew Duong
    • 1
  • Olufemi R. Ayeni
    • 1
    • 3
    Email author
  1. 1.Division of Orthopaedic Surgery, Department of SurgeryMichael G. DeGroote School of MedicineHamiltonCanada
  2. 2.Department of MedicineNorthern Ontario School of MedicineThunder BayCanada
  3. 3.McMaster University Medical CenterHamiltonCanada

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