Author Response Regarding “The Long-Term Outcome After Early and Late Anterior Cruciate Ligament Reconstruction”

Karikis, Ioannis; Kartus, Jüri

doi:10.1016/j.arthro.2018.06.018

Cited by 1 publication

(6 citation statements)

References 10 publications

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“…With regard to patient characteristics, almost all studies reported data on sex and age, most of them showing no significant difference between early and delayed groups regarding sex and age. Data for level of activity and mechanism of injury of patient groups were reported in some of the studies (Table 2) and did not show any significant difference between groups when reported, 6,24,35 apart from 1 study that reported a significantly higher rate of sports injuries in the early group. 41 In total, 2 studies reported on BMI of patients in both patient groups, showing no significant difference between early and delayed groups.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 97%

“…29 Among the studies, there were 3 RCTs, 6,28,35 2 prospective cohort studies, 26,30 and 7 retrospective cohort studies. 2,8,[23][24][25]27,41 The total number of participants included in the analysis from these studies was 3042.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Almost all studies (11/12) reported more MM tears in the delayed groups of ACL reconstruction, with 6 studies showing a statistically significant difference. 2,8,[23][24][25]28 Two of these studies made a clear recommendation to perform an ACL reconstruction early to minimize the risk of MM tears. 23,25 There was no difference in LM tears between early and delayed groups of ACL reconstruction, with only 1 study (RCT) reporting significantly increased LM tears in the early group.…”

Section: Meniscal Tearsmentioning

confidence: 99%

“…Regarding treatment of meniscal tears, 6 studies reported data for type of treatment (Table 3). 6,24,26,28,30,35 Two studies mentioned that tears amenable to repair were excluded and that all included meniscal tears were debrided or partially excised. 26,35 One study reported that peripheral longitudinal tears were repaired, but white-white zone degenerative or complex tears were partially excised.…”

Section: Meniscal Tearsmentioning

confidence: 99%

“…30 A further 3 studies reported on meniscal tears that were amenable to repair, with a significantly higher rate of meniscal tears being repairable in the early groups, whereas higher rates of meniscal tears were debrided or partially excised in the delayed groups. 6,24,26 One of these studies, which reported on meniscal tears that were repaired, also showed that women had more MM tears excised and less MM tears repaired during delayed ACL reconstruction. 26 With regard to the correlation of meniscal tears with other patient characteristics, one of the retrospective studies showed significant correlation of age (P = .001) and BMI (P = .039) with MM tears, whereas LM tears were correlated with age (P = .014) and male sex (P = .046).…”

Section: Meniscal Tearsmentioning

confidence: 99%

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Timing of Anterior Cruciate Ligament Reconstruction and Relationship With Meniscal Tears: A Systematic Review and Meta-analysis

et al. 2020

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Background: Anterior cruciate ligament (ACL) ruptures are common, but the ideal timing for ACL reconstruction after injury is unclear with regard to meniscal insult. Purpose: To determine whether there is a relationship between timing from ACL rupture to ACL reconstruction and development of meniscal tears within this period. Study Design: Systematic review and meta-analysis. Methods: A systematic literature search was undertaken independently by 2 reviewers using the Cochrane method for systematic reviews in 5 online databases. The reviewers performed independent data extraction and assessment of risk of bias and study quality. The search included any comparative study, including randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case-control studies of an adult population, that assessed the relationship between timing of ACL reconstruction surgery and rates of meniscal tears. Results: After screening, 12 studies (No. of participants = 3042) out of 3390 records were included for analysis: 3 RCTs (n = 272), 2 prospective cohort studies (n = 307), and 7 retrospective cohort studies (n = 2463). In analysis of these studies, rates of reported meniscal tears were compared for ACL procedures performed at 3 and 6 months after injury. Meta-analysis of 5 studies (n = 2012) showed that ACL reconstruction performed >3 months after injury was associated with a higher rate of medial meniscal tears compared with ACL reconstruction performed within 3 months of injury (estimated OR, 2.235; 95% CI, 1.183-4.223; P = .013) but not with a higher rate of lateral meniscal tears. Similarly, meta-analysis of 4 studies (n = 990) showed that ACL reconstruction performed >6 months after injury was associated with a higher rate of medial meniscal tears compared with ACL reconstruction performed within 6 months of injury (estimated OR, 2.487; 95% CI, 1.241-4.984; P = .01) but not with a higher rate of lateral meniscal tears. Conclusion: Our results suggest that delay of ACL reconstruction surgery >3 months after injury is associated with a higher rate of medial meniscal tears within this prereconstruction time frame. Further high-quality prospective studies may help determine whether this is a causal effect. However, based on current evidence, in those patients for whom ACL reconstruction is indicated, ACL reconstruction within 3 months of injury may be recommended. Registration: CRD42016032846 (PROSPERO)

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