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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-02-2017 | Knee

Impact of surgical timing on the outcome of anterior cruciate ligament reconstruction

Authors: Elmar Herbst, Christian Hoser, Peter Gföller, Caroline Hepperger, Elisabeth Abermann, Katharina Neumayer, Volker Musahl, Christian Fink

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2017

Abstract

Purpose

The purpose of the present study is the comparison of acute ACL reconstruction with or without meniscus repair within 48 h after injury and a delayed surgery during the inflammation-free interval. It was hypothesized that acute ACL reconstruction results in inferior patient reported outcomes and higher frequency of range of motion deficits.

Methods

The effect of acute (within 48 h) and delayed (during the inflammation-free interval) ACL surgery was prospectively studied on 160 consecutive patients with ACL injury between January 2010 and December 2011. Subgroup analyses were performed to evaluate patients with an additional meniscus repair separately from isolated ACL surgeries. During the study period, partial meniscectomies were recorded to evaluate time dependent meniscus reparability. Patient reported outcomes, objective IKDC and manual stability measurements were documented during the 24-month follow-up period. The Pearson Chi-squared test was used to evaluate objective outcome measures. The Mann–Whitney U test was performed to analyse the results of patient reported outcomes. Statistical significance was set at p < 0.05.

Results

For patients who underwent isolated ACL reconstruction, no statistical significant difference was observed at any time point regarding objective and subjective outcome measures. Significantly fewer patients who underwent acute combined ACL reconstruction and meniscus repair had an extension deficit between 3° and 5° at 12 months following surgery (3.7 vs. 22.2 %, p < 0.05). No difference regarding cyclops removal, re-injury of ACL or meniscus was found between the two surgical timing groups. Further, surgical timing did not influence the reparability of the meniscus.

Conclusion

An acute ACL reconstruction within 48 h is preferable in highly active patients or competitive athletes.

Level of evidence

Prospective cohort study, Level II.

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Title: Impact of surgical timing on the outcome of anterior cruciate ligament reconstruction
Authors: Elmar Herbst
Christian Hoser
Peter Gföller
Caroline Hepperger
Elisabeth Abermann
Katharina Neumayer
Volker Musahl
Christian Fink
Publication date: 01-02-2017
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-016-4291-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of surgical timing on the outcome of anterior cruciate ligament reconstruction

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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