Table 2

Certainty of Evidence (GRADE approach) of meta-analytic outcomes

Outcome (follow-up time point)Studies included in meta-analysisTotal NInterventionControlEffect size
(95% CrI)		95% prediction interval*Raw mean difference†/risk difference‡
(95% CrI)		Certainty rating
Primary outcomes
Self-reported knee function§
(Short-term)		Frobell et al 54, Reijman et al 53 288Early reconstructionRehabilitation+optional reconstructionSMD −0.25,
(−0.84 to 0.36)		(−1.25 to 0.76)−4.21,
(−14.27 to 6.07)
IKDC
(0–100)		 Low¶
Self-reported knee function§
(Medium-term)		Frobell et al 54, Reijman et al 53 288Early reconstructionRehabilitation+optional reconstructionSMD −0.10,
(−0.59 to 0.41)		(−0.91 to 0.72)−2.65,
(−15.94 to 10.89)
IKDC
(0–100)		 Low¶
Self-reported knee function§
(Long-term)		Frobell et al 55, Tsoukas et al 52 152Early reconstructionRehabilitation+optional reconstructionSMD −0.21,
(−1.49 to 0.81)		(−2.28 to 1.58)−0.96,
(−5.79 to 3.95)
IKDC
(0–100)		 Very low¶**
Self-reported knee function§
(All time points combined)		Frobell et al 54, Reijman et al 53, Tsoukas et al 52 309Early reconstructionRehabilitation+optional reconstructionSMD −0.27
(−0.84 to 0.21)		(−1.29 to 0.66)−5.07,
(−15.70 to 3.99)
IKDC
(0–100)		 Low¶
Radiological knee osteoarthritis (Long-term)Frobell et al 55,
Tsoukas et al 52 		152Early reconstructionRehabilitation+optional reconstruction*OR 1.45,
(0.30 to 5.17)		(0.18 to 10.0)−72 per 1000 patients,
(144 to −384)		 Very low¶**††
Secondary outcomes
Health-related quality of life‡‡ (Medium-term)Frobell et al.54, Reijman et al(53 288Early reconstructionRehabilitation+optional reconstructionSMD −0.40,
(−0.88 to 0.09)		(−1.18 to 0.40)−5.91,
(−13.05 to 1.32)
SF-36 mental health score
(0–100)		 Low¶
Health-related quality of life‡‡
(All time points combined)		Frobell et al 54, Reijman et al 53 288Early reconstructionRehabilitation+optional reconstructionSMD −0.35
(−0.87 to 0.16)		(−1.20 to 0.50)−5.01,
(−12.37 to 2.34)
SF-36 mental health score
(0–100)		 Low¶
Self-reported return to activity§§ (Medium-term)Frobell et al 54, Reijman et al 53 288Early reconstructionRehabilitation+optional reconstructionSMD −0.10,
(−0.57 to 0.38)		(−0.87 to 0.68)−0.31,
(−1.80 to 1.19)
Tegner Scale
(0–10)		 Very low¶††
Self-reported return to activity§§
(Long-term)		Frobell et al 55,
Tsoukas et al 52 		152Early reconstructionRehabilitation+optional reconstructionSMD −0.22,
(−0.92 to 0.39)		(−1.32 to 0.77)−0.75,
(−2.92 to 1.23)
Tegner Scale
(0–10)		 Very low¶**††
Self-reported return to activity§§
(All time points combined)		Frobell et al 54, Reijman et al 53, Tsoukas et al 52 309Early reconstructionRehabilitation+optional reconstructionSMD −0.21,
(−0.57 to 0.13)		(−0.82 to 0.37)−0.72,
(−1.92, 0.42)
Tegner Scale
(0–10)		 Very low¶††
Adverse event – graft rupture Frobell et al 54, Reijman et al 53 288Early reconstructionRehabilitation+optional reconstructionOR 2.3,
(0.4 to 12.4)		(0.3 to 20)−26 per 1000 patients,
(12, -186)		 Very low¶††

  • Negative standardised mean differences indicate the effect favoured the intervention.

  • *The prediction interval indicates the heterogeneity in the data and the range of potential values that could be possible in future studies.

  • †Raw data estimate was done by multiplying the SMD and associated 95% credible interval estimates by the available pooled SD from studies included in the review.

  • ‡Raw data estimate used the median comparator baseline risk of included studies.

  • §International Knee Documentation Committee (IKDC Questionnaire) (Reijman et al. and Tsoukas et al.), Knee Injury and Osteoarthritis Outcome Score (KOOS) (Frobell et al)

  • ¶Certainty rated down for inconsistency.

  • **Certainty rated down for risk of bias.

  • ††Certainty rated down for imprecision, e: certainty rated down for publication.

  • ‡‡SF-36 (mental subscale) (Frobell et al), KOOS subscale Quality of Life (Reijman et al).

  • §§Tegner Scale (Frobell et al. and Tsoukas et al), Lysholm Scale (Reijman et al).

  • DR, delayed reconstruction; ER, early reconstruction; NA, not applicable; NO, non-operative.