How Are We Matching in ACL Reconstruction Research? A Systematic Review of Methods, Reporting, and Covariate Selection.

67 , 97 As the volume of ACLR procedures grows and clinical techniques evolve, there has been an increasing trend to utilize observational study designs to evaluate outcomes, guide clinical practice, and inform decisions. 17 , 53 , 78 , 98 Given the inherent limitations of nonrandomized studies, particularly the risk of selection bias and confounding variables, researchers have increasingly adopted matching techniques to improve internal validity. 66 , 75 Patient matching, whether through direct covariate matching or propensity score matching (PSM), offers a practical way to create comparable groups in observational research.

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