May 2012

ACL reconstruction delays increase risk of meniscal, chondral injuries

In the moment: Surgery

By Jordana Bieze Foster

Research from the University of Hong Kong provides further evidence that delaying anterior cruciate ligament surgery increases the risk of meniscal injury and articular cartilage lesions, both of which are associated with increased long-term risk of knee osteoarthritis.

Investigators analyzed 150 patients who had undergone ACL reconstruction. Meniscal injuries were identified at surgery in 99 patients and cartilage lesions in 66.

Patients who underwent surgery within 12 months of ACL injury were significantly less likely to exhibit meniscal injuries than those whose surgery was delayed. Meniscal injuries identified within 12 months were also significantly more likely to be repaired. Time to surgery in patients with cartilage lesions was significantly longer than in patients without cartilage lesions (mean time, 18.9 vs 12.1 months).

The findings, e-published on May 3 by Knee Surgery, Sports Traumatology, Arthroscopy, are consistent with those of a May 2011 Journal of Bone & Joint Surgery study in which a decision analysis model predicted significantly higher rates of meniscectomy in patients who delayed ACL reconstruction than in those who did not. –JBF

Sources:

Fok AW, Yau WP. Delay in ACL reconstruction is associated with more severe and painful meniscal and chondral injuries. Knee Surg Sports Traumatol Arthrosc 2012 May 13. [Epub ahead of print]

Bernstein J. Early versus delayed reconstruction of the anterior cruciate ligament: a decision analysis approach. J Bone Joint Surg Am 2011;93(9):e48.

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