Suture Tape Augmentation in Anterior Cruciate Ligament Reconstruction: A Meta-Analysis of Prospective and Matched Retrospective Studies.

Background: Previous biomechanical studies have shown that suture tape augmentation (STA) in anterior cruciate ligament reconstruction (ACLR) can improve the graft which can translate to reduced failure rate in a clinical setting. Previous meta-analysis did not show benefits to STA in patients undergoing ACLR. However, the included studies were retrospective and are subject to heterogeneity which can result in confounding bias. By including only prospective and matched retrospective studies, this meta-analysis will assess the benefits of STA in patients undergoing ACLR. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Cochrane, and Google Scholar were accessed and explored until November 2025. The extracted data consisted of the risk arthrofibrosis, graft failure, return to sports (RTS), time to RTS, and postoperative functional outcomes (The Knee Injury and Osteoarthritis Outcome Score [KOOS] subscales and The International Knee Documentation Committee [IKDC] scale). Results: Six studies met the final inclusion criteria including 414 patients in the STA group with age ranging from 19 to 36 years and 450 patients in the control group with age ranging from 20 to 39 years. There was no difference between the 2 groups in arthrofibrosis, graft failure, RTS, and time to RTS. In addition, there were no differences in postoperative KOOS pain, symptoms, activities of daily living, sports, and quality of life subscales as well as IKDC. Conclusion: The results of this meta-analysis revealed that the systematic use of STA did not provide additional clinical benefits in patients older than 18 years undergoing ACLR.