Effect of surgical timing on recovery and associated injuries after anterior cruciate ligament reconstruction

Abstract

This study was undertaken to determine the optimal time after injury for arthroscopically assisted anterior cruciate ligament reconstruction using a double semitendinosus graft. We analyzed 87 patients. Time from injury to surgery was established as acute, subacute, or chronic; the three groups were matched. Meniscal damage and treatment were categorized. Chondral lesions were graded, postoperative parameters of motion, strength recovery, and stability were tabulated at 3, 6, 12, and 18 months. Complications were compared. Six percent of the patients with chronic knee injuries had two normal menisci at surgery, compared with 29% of the acute and subacute groups. Reparable tears were found in 37.8% of the knees. Chondral lesions were found in the tibiofemoral joint in 17% of acute, 7% of subacute, and 44% of the chronic knees. Postoperative motion recovery was significantly less at all time intervals for the acute group. Quadriceps strength recovery was slower in the acute knees. Stability was similar in all groups. Arthrofibrosis was found in 22% of acute, 0 subacute, and 12.5% of the chronic knees. Patellofemoral pain was noted in 17% of the acute, 0 of the subacute, and 9.3% of the chronic knees. This study showed that surgery done within 6 months of injury does not jeopardize the knee. Recovery after acute anterior cruciate ligament reconstruction is significantly slower than after subacute or chronic reconstruction.