HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wasilewski, S. A. Articles by Cohen, S. Search for Related Content PubMed Articles by Wasilewski, S. A. Articles by Cohen, S.

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

Sun Valley Sports Medicine, Sun Valley, Idaho

David J. Covall, MD

Boston University Medical Center, Boston,

Sharon Cohen, PT

Department of Physical Therapy, Lahey Clinic, Burlington, Massachusetts, Department of Physical Therapy, Lahey Clinic, Burlington, Massachusetts, Boston University Medical Center, Boston,

This study was undertaken to determine the optimal time after injury for arthroscopically assisted anterior cruciate ligament reconstruction using a double semi tendinosus 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 le sions were graded, postoperative parameters of mo tion, strength recovery, and stability were tabulated at 3, 6, 12, and 18 months. Complications were com pared.

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. Sta bility 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 sig nificantly slower than after subacute or chronic recon struction.

This article has been cited by other articles:

				C. R. Bottoni, T. R. Liddell, T. J. Trainor, D. M. Freccero, and K. K. Lindell Postoperative Range of Motion Following Anterior Cruciate Ligament Reconstruction Using Autograft Hamstrings: A Prospective, Randomized Clinical Trial of Early Versus Delayed Reconstructions Am. J. Sports Med., April 1, 2008; 36(4): 656 - 662. [Abstract] [Full Text] [PDF]

				D. Magit, A. Wolff, K. Sutton, and M. J. Medvecky Arthrofibrosis of the Knee J. Am. Acad. Ortho. Surg., November 1, 2007; 15(11): 682 - 694. [Abstract] [Full Text] [PDF]

				G. W. Woods and D. P. O'Connor Delayed Anterior Cruciate Ligament Reconstruction in Adolescents With Open Physes Am. J. Sports Med., January 1, 2004; 32(1): 201 - 210. [Abstract] [Full Text]

				G.-S. Huang, C.-H. Lee, W. P. Chan, H.-S. Lee, C.-Y. Chen, and J. S. Yu Acute Anterior Cruciate Ligament Stump Entrapment in Anterior Cruciate Ligament Tears: MR Imaging Appearance Radiology, November 1, 2002; 225(2): 537 - 540. [Abstract] [Full Text] [PDF]

				P. J. Millett, T. L. Wickiewicz, and R. F. Warren Motion Loss after Ligament Injuries to the Knee: Part I: Causes Am. J. Sports Med., September 1, 2001; 29(5): 664 - 675. [Abstract] [Full Text] [PDF]

				T. N. LINDENFELD, E. M. WOJTYS, and A. HUSAIN Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Operative Treatment of Arthrofibrosis of the Knee*{{dagger}} J. Bone Joint Surg. Am., December 1, 1999; 81(12): 1772 - 84. [Full Text]

				P. J. Millett, R. J. Williams III, and T. L. Wickiewicz Open Debridement and Soft Tissue Release as a Salvage Procedure for the Severely Arthrofibrotic Knee Am. J. Sports Med., September 1, 1999; 27(5): 552 - 561. [Abstract] [Full Text] [PDF]

				T. Muneta, Y. Ezura, I. Sekiya, and H. Yamamoto Anterior Knee Laxity and Loss of Extension After Anterior Cruciate Ligament Injury Am. J. Sports Med., September 1, 1996; 24(5): 603 - 607. [Abstract] [PDF]

				K. D. Shelbourne and D. A. Foulk Timing of Surgery in Acute Anterior Cruciate Ligament Tears on the Return of Quadriceps Muscle Strength After Reconstruction Using an Autogenous Patellar Tendon Graft Am. J. Sports Med., December 1, 1995; 23(6): 686 - 689. [Abstract] [PDF]

				M. Marcacci, S. Zaffagnini, F. Iacono, M. Pia Neri, and A. Petitto Early Versus Late Reconstruction for Anterior Cruciate Ligament Rupture: Results After Five Years of Followup Am. J. Sports Med., December 1, 1995; 23(6): 690 - 693. [Abstract] [PDF]

				E. Arendt and R. Dick Knee Injury Patterns Among Men and Women in Collegiate Basketball and Soccer: NCAA Data and Review of Literature Am. J. Sports Med., December 1, 1995; 23(6): 694 - 701. [Abstract] [PDF]

				S. Murakami, T. Muneta, K. Furuya, I. Saito, N. Miyasaka, and H. Yamamoto Immunohistologic Analysis of Synovium in Infrapatellar Fat Pad After Anterior Cruciate Ligament Injury Am. J. Sports Med., December 1, 1995; 23(6): 763 - 768. [Abstract] [PDF]