Comparing Clinical Outcomes of Early and Elective Reconstruction in Patients with Anterior Cruciate Ligament Tears

Authors

  • Sombun Wutphiriyaangkun, MD Department of orthopaedic surgery, Sawangdaendin Crown prince Hospital, Sakon Nakhon, Thailand

DOI:

https://doi.org/10.56929/jseaortho-2023-0194

Keywords:

early reconstruction, elective reconstruction, anterior cruciate ligament reconstruction, anterior cruciate ligament tears

Abstract

Purpose: The optimal time of treatment for anterior cruciate ligament tears remains controversial. Two times are early (< 6 weeks) and elective (≥ 6 weeks) reconstruction. This retrospective study tested the hypothesis that clinical outcomes are similar between the two time groups for anterior cruciate ligament reconstruction.

Methods: A total of 61 patients were included in this study. Thirty and 31 patients were in the early and elective reconstruction groups, respectively. The collected patient data included a preoperative and 2-year postoperative range of motion, visual analog scale scores, anterior stability tests, and clinical knee scores.

Results: There were no significant differences in the 2-year postoperative range of motion, visual analog scale scores, or anterior stability tests. The Lysholm and International Knee Documentation Committee knee evaluation form scores were significantly higher in the early reconstruction group than in the elective reconstruction group.

Conclusions: Early anterior cruciate ligament reconstruction is a more effective clinical knee score than elective reconstruction in treating anterior cruciate ligament tears.

Metrics

Metrics Loading ...

References

Forsythe B, Lu Y, Agarwalla A, et al. Delaying ACL reconstruction beyond 6 months from injury impacts likelihood for clinically significant outcome improvement. Knee 2021;33:290-7. DOI: https://doi.org/10.1016/j.knee.2021.10.010

Dunn KL, Lam KC, Valovich McLeod TC. Early operative versus delayed or nonoperative treatment of anterior cruciate ligament injuries in pediatric patients. J Athl Train 2016;51:425-7. DOI: https://doi.org/10.4085/1062-6050.51.5.11

Shelbourne KD, Patel DV. Timing of surgery in anterior cruciate ligament-injured knees. Knee Surg Sports Traumatol Arthrosc 1995;3:148-56. DOI: https://doi.org/10.1007/BF01565474

Melikoglu MA, Balci N, Samanci N, et al. Timing of surgery and isokinetic muscle performance in patients with anterior cruciate ligament injury. J Back Musculoskelet 2008;21:23-8. DOI: https://doi.org/10.3233/BMR-2008-21103

Reijman M, Eggerding V, Van Es E, et al. Early surgical reconstruction versus rehabilitation with elective delayed reconstruction for patients with anterior cruciate ligament rupture: COMPARE randomised controlled trial. BMJ 2021;372(375). DOI: https://doi.org/10.1136/bmj.n375

Prodromidis AD, Drosatou C, Thivaios GC, et al. Timing of anterior cruciate ligament reconstruction and relationship with meniscal tears: a systematic review and meta-analysis. Am J Sports Med 2021;49:2551-62. DOI: https://doi.org/10.1177/0363546520964486

Barenius B, Nordlander M, Ponzer S, et al. Quality of life and clinical outcome after anterior cruciate ligament reconstruction using patellar tendon graft or quadrupled semitendinosus graft: an 8-year follow-up of a randomized controlled trial. Am J Sports Med 2010;38:1533-41. DOI: https://doi.org/10.1177/0363546510369549

Fithian DC, Paxton EW, Stone ML, et al. Prospective trial of a treatment algorithm for the management of the anterior cruciate ligament-injured knee. Am J Sports Med 2005;33:335-46. DOI: https://doi.org/10.1177/0363546504269590

Rose T, Engel T, Bernhard J, et al. Differences in the rehabilitation period following two methods of anterior cruciate ligament replacement: semitendinosus/gracilis tendon vs. ligamentum patellae. Knee Surg Sports Traumatol Arthrosc 2004;12:189-97. DOI: https://doi.org/10.1007/s00167-003-0438-8

Hunter RE, Mastrangelo J, Freeman JR, et al. The impact of surgical timing on postoperative motion and stability following anterior cruciate ligament reconstruction. Arthroscopy 1996;12:667-74. DOI: https://doi.org/10.1016/S0749-8063(96)90168-1

Wasilewski SA, Covall DJ, Cohen S. Effect of surgical timing on recovery and associated injuries after anterior cruciate ligament reconstruction. Am J Sports Med 1993;21:338-42. DOI: https://doi.org/10.1177/036354659302100302

Eriksson K, von Essen C, Jönhagen S, et al. No risk of arthrofibrosis after acute anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2018;26:2875-82. DOI: https://doi.org/10.1007/s00167-017-4814-1

Deabate L, Previtali D, Grassi A, et al. Anterior cruciate ligament reconstruction within 3 weeks does not increase stiffness and complications compared with delayed reconstruction: a meta-analysis of randomized controlled trials. Am J Sports Med 2020;48:1263-72. DOI: https://doi.org/10.1177/0363546519862294

Smith TO, Davies L, Hing CB. Early versus delayed surgery for anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2010;18:304-11. DOI: https://doi.org/10.1007/s00167-009-0965-z

Voss A, Pfeifer CG, Kerschbaum M, et al. Post-operative septic arthritis after arthroscopy: modern diagnostic and therapeutic concepts. Knee Surg Sports Traumatol Arthrosc 2021;29:3149-58. DOI: https://doi.org/10.1007/s00167-021-06525-8

Downloads

Published

2023-10-05

How to Cite

1.
Wutphiriyaangkun S. Comparing Clinical Outcomes of Early and Elective Reconstruction in Patients with Anterior Cruciate Ligament Tears. JseaOrtho [Internet]. 2023 Oct. 5 [cited 2024 Jul. 27];48(1):15-21. Available from: https://jseaortho.org/index.php/jsao/article/view/194

Issue

Section

Original Articles