Anterior cruciate ligament insufficiency: does delay in index surgery affect outcome in recreational athletes

Abstract

The aim of the study was to see if delay in anterior cruciate ligament (ACL) reconstruction affects post-reconstruction outcome in recreational athletes. Sixtytwo recreational athletes who had arthroscopic ACL reconstructions using quadruple hamstring grafts between 1997 and 2000 were retrospectively evaluated. Patients with less than 2 years' follow-up, those with multi-ligament injuries, reconstructions for previous failed repairs, those whose injury date was unknown, those with pre-injury Tegner activity level greater than 7 (competitive athletes) and those lost to follow-up were all excluded. Forty-six patients (38 males) were entered. The mean follow up was 38 months and the mean time from injury to index ACL reconstruction was 27 months. Apart from two revisions there were no other significant complications. Forty-one (89%) patients were evaluated in a review clinic. There was a significant improvement in the post-reconstruction Lysholm scores and an improvement in the Tegner scores. The Spearman's correlation coefficient between postoperative Lysholm score and the delay until surgery was −0.18 and the correlation coefficient between postoperative Tegner scores and the delay until surgery was 0.14. Thirty-five patients returned to sporting activity. Thirty-seven rated their knee as being normal or nearly normal and 35 said that their knee function was as they had expected it to be. Late ACL reconstruction does not adversely affect the outcome in recreational athletes. ACL reconstruction should be offered to these patients as there is a significant improvement in the knee function and patients are satisfied with the results.Résumé Le but de cette étude est d'analyser les résultats d'une reconstruction du ligament croisé antérieur retardée chez les sportifs de loisir. Soixante-deux sportifs de loisir ont eu une réparation arthroscopique du ligament croisé antérieur en utilisant les muscles de la patte d'oie, entre 1997 et 2000. Il s'agit d'une étude rétrospective. Ont été exclus de cette étude les patients qui ont moins de deux ans de recul et/ou avec de nombreuses lésions ligamentaires, la réparation du ligament croisé antérieur secondaire à un échec d'intervention antérieure et ceux dont on ne connaissait pas la date exacte du traumatisme initial. Ont été également exclus les athlètes de compétition (7) et les patients perdus de vue. Quarante-six patients (38 de sexe masculin) ont été analysés, le suivi moyen a été de 38 mois et le délai moyen entre le traumatisme initial et la réparation du ligament croisé antérieur a été de 27 mois. En dehors de deux reprises, il n'y a pas eu de complications significatives. Quarante et un (89%) patients ont été évalués cliniquement lors de la revue. Le score de corrélation de Spearman mettant en relation le score de Lysholm postopératoire et le délai moyen d'intervention a été de −0,18 de même en ce qui concerne le coefficient de corrélation post-opératoire de Tegner et le délai moyen de l'intervention donnant un résultat à 0,14. Trente-cinq patients ont repris...

Does Anterior Cruciate Ligament Reconstruction Lead to Degenerative Disease?

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Risk factors for medial meniscal injury in association with cranial cruciate ligament rupture

“…The optimal time for surgery has not been established and remains a contentious issue in the surgery of human beings. Although there is good evidence that delayed surgery results in a greater prevalence of meniscal tears (Keene and others 1993, Millett and others 2002), articular cartilage damage (Smith and others 2002, Nelson and others 2006) and soft‐tissue atrophy, some studies suggest that a delay in the index surgery does not affect the short to medium term functional outcome in most human patients (Tambe and others 2006). However, it is generally accepted that the chondral consequences of delayed surgery can be associated with the progression of osteoarthritis (Nelson and others 2006) and a poorer outcome in the longer term in human patients (Marcacci and others 1995, Magnussen and others 2009,).…”

Low re-rupture rate with BPTB autograft and semitendinosus gracilis autograft with preserved insertions in ACL reconstruction surgery in sports persons

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