Impact of Early vs Delayed Anterior Cruciate Ligament Reconstruction on Tibiofemoral Laxity

Optimal timing of anterior cruciate ligament reconstruction (ACLR) remains controversial. This study evaluated the impact of timing of ACLR on rates of revision, return to the operating room, and pre- and postoperative tibiofemoral laxity.

A retrospective review was performed from January 1, 2010, to December 31, 2015, and included patients ≥ 16 years of age with no history of prior ipsilateral or contralateral knee surgery who underwent primary arthroscopic ACLR. Patients were categorized as early ACLR (< 6 months postinjury) or delayed ACLR (≥ 6 months). Pre- and postoperative manual-maximum differences (MMDs) based on KT-1000 testing and postoperative pivot shift were examined.

A total of 611 patients met inclusion criteria (n = 198 early ACLR and n = 413 delayed ACLR). Compared to the early ACLR group, patients receiving delayed ACLR had a lower preoperative MMD (mean 6.55 vs 7.27 mm). Postoperative MMD, as measured by a single physical therapist, was not significantly different for early vs delayed reconstruction. Logistic regression controlling for age, graft type, and postoperative laxity revealed that delayed ACLR was associated with lower odds of return to the operating room (odds ratio = 0.523, P = .045).

Delayed ACLR was associated with a lower return to the operating room and no difference in postoperative MMD.