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Table 3 Summary of the Studies that Used Total Maturation Score or Grading System

From: Evaluation parameters of graft maturation on second-look arthroscopy following anterior cruciate ligament reconstruction: a systematic review

 

Method

Correlation with clinical outcomes

Kondo et al. [7] (Arthroscopy, 2007)

Graft maturation score for each bundle based on graft tension (0–2)* and integrity (0–2). Each bundle (AM, PL) with a total score of 4 was evaluated as excellent, 2 or 3 as fair, and 0 or 1 as poor. DB grafts were classified into categories I (two excellent bundles), II (only one excellent bundle), or III (no excellent bundle)

Category I showed significantly better results than categories II or III in KT-2000 and PST

No significant differences between the three categories in all clinical outcomes.

Ahn et al. [9] (Arthroscopy, 2015)

Graft maturation score based on integrity (0–3), tension (0–3), and synovial coverage with neo-vascularization (0–4). Total graft maturation scores ranged from 0 to 10 points

No comparison between second-look findings and objective outcomes, but remnant preserved group showed higher graft maturation score and better clinical outcomes

Kondo et al. [17] (AJSM, 2015)

Graft maturation score and grade system by Kondo and Yasuda were used

No comparison between second-look findings and objective outcomes, but remnant preserved group showed better maturation grade and stability (KT-2000, PST)

Lu et al. [18] (AJSM, 2015)

Graft maturation score based on synovial and vascular coverage, tension, integrity. A maximum of 2 points was assigned for each parameter. A graft with a total score of 5 or 6 was evaluated as excellent, 3 or 4 as fair, and ≤ 2 as poor

No comparison between second-look findings and objective clinical outcomes. But ACLR using the existing footprint remnant for tunnel placement showed higher graft maturation score and better functional results (ROM recovery, subjective outcome scores)

Kim et al. [10] (KSSTA, 2017)

Total maturation score based on graft tension, integrity, and synovial coverage (modified from method by Ohsawa et al. [28]). According to the second-look finding, a maximum of 3 points was assigned for each parameter. Total scores ranged from 3 to 9 points

No comparison between total maturation score and clinical outcomes

Kim et al. [11] (KSSTA, 2017)

Total maturation score based on graft tension, integrity, synovial coverage, and revascularization. According to the second-look finding, a maximum of 2 points was assigned for each parameter. Total scores ranged from 0 to 8 points

No comparison between total maturation score and clinical outcomes

Matsushita et al. [12] (KSSTA, 2017)

Graft maturation grade and category system by Kondo and Yasuda [17]

No comparison between total maturation grade/category and clinical outcomes

  1. *Assigned score for each parameter in blank. AM anteromedial bindle, PL posterolateral bundle, DB double bundle, ACLR anterior cruciate ligament reconstruction
  2. AJSM The American Journal of Sports Medicine, KSSTA Knee Surgery, Sports Traumatology, Arthroscopy