Abstract
Objectives:
This systematic review aims to synthesize the existing evidence regarding the comparative outcomes, specifically International Knee Documentation Committee (IKDC) and Lysholm scores, associated with early (within 14-21 days of injury) versus late (after 28-60 days of injury) ACL reconstruction.
Methods:
A systematic search was conducted across databases including PubMed and MEDLINE, utilizing specific keywords related to ACL reconstruction timing. Studies comparing early and late ACL reconstruction, with a primary focus on IKDC and Lysholm scores, were selected for inclusion. The selected studies were critically reviewed and analyzed.
Results:
Five studies meeting the inclusion criteria were identified. Raviraj et al reported no significant difference in Lysholm scores between early (83.1) and late (84.2) reconstruction groups, with two cases of superficial wound infection in the early group. Karikis et al demonstrated superior early outcomes (86.8) compared to late reconstruction (77.9), associated with fewer meniscal tears. Reijman et al used IKDC scores but did not report complications. Von Essen et al observed favorable IKDC scores in both groups, with fewer additional surgeries in the early group. Notably, Manandhar et al found marginal differences in outcomes with unspecified measures, with one infection in the early group.
Conclusion:
This systematic review of the available literature reveals mixed findings regarding the optimal timing of ACL reconstruction concerning IKDC and Lysholm scores. While some studies suggest comparable outcomes between early and late reconstruction, others indicate potential advantages of early intervention, including better IKDC scores and reduced meniscal injuries. Given the variability in study methodologies and outcome measures, further research with standardized assessments, larger sample sizes, and longer-term follow-up is warranted. Clinicians should carefully consider individual patient factors and goals when making decisions regarding the timing of ACL reconstruction.