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Early anterior cruciate ligament reconstruction can save meniscus without any complications
Chang-Ik Hur1, Eun-Kyoo Song1, Sung-Kyu Kim1
1Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Bitgoeul Hospital, Gwangju, Korea.
Background:
Early ACL reconstruction, before retuning to activity eliminates recurrent episodes of instability and thereby decreases chances of meniscal and cartilage injury. However, there are no clear and uniform guidelines regarding the timing of ACL reconstruction or clarity in the definition of early and delayed reconstruction to reduce the complications after reconstruction in the ACL injured knee. The purpose of this study was to compare the clinical outcome, stability, muscle power, and postural control after early and delayed anterior cruciate ligament (ACL) reconstruction.
Materials And Methods:
Patients who had ACL reconstruction with a quadruple hamstring tendon with a minimum 2-year followup were evaluated. Early (within 3 weeks) reconstruction group was 48 knees and delayed (more than 3 months) group was 43 knees. We compared the two groups with regard to Lysholm knee score, range of motion (ROM), Lachman test, Tegner activity scale, associated meniscal or chondral injuries, and anterior laxity. We also compared muscle strength with an isokinetic dynamometer and postural control with computed dynamic posturography at the final followup.
Results:
While 50% of early and 70% of delayed group had meniscal injuries (P = 0.06), of which were reparable in 42% of early group and 17% of delayed group (P = 0.04). However, there was no significant difference in cartilage injury (P = 0.14). At the final followup, no significant differences were found between two groups for Lysholm score (P = 0.28), Tegner activity scale (P = 0.27), and ROM. The stabilities regarding Lachman and pivot-shift tests, and anterior laxity also showed no significant differences between two groups. The mean extension and flexion muscles power, and postural control showed no significant inter-group differences (P > 0.05).
Conclusions:
Early ACL reconstruction had excellent clinical results and stability as good as delayed reconstruction without the problem of knee motion, muscle power, and postural control. Moreover, early reconstruction showed the high possibility of meniscal repair. Therefore, early ACL reconstruction should be recommended.