Abstract
Objectives:
The optimal timing to perform an anterior cruciate ligament reconstruction (ACLR) has still become a debatable topic. Previous studies have suggested that an ACLR performed after six months resulted in inferior outcomes. However, those findings were opposed by the results from recent studies. Therefore, our aim is to determine the clinical outcomes of ACLR performed ≤6 months compared to ACLR >6 months. In addition, we also aim to assess the likelihood of requiring a meniscus repair and partial meniscectomy for a delayed ACLR.
Methods:
This is a retrospective cohort study that included all patients who underwent an ACLR at our institution between January 2020–January 2022. Patients with partial-thickness ACL tear, other concomitant ligament involvement, contralateral ligament involvement, and incomplete medical records were excluded. Patients were divided into two groups: ACLR ≤6 months and ACLR >6 months. The International Knee Documentation Committee (IKDC) score and Knee Injury and Osteoarthritis Outcomes Score (KOOS) were used to assess each patient’s clinical outcomes.
Results:
In total, 91 patients were included in this study, consisting of 61 patients in the ACLR ≤6 months group (67.0%) and 30 patients in the ACLR >6 months group (33.0%). The IKDC score (84.40 ± 6.83 vs 82.68 ± 5.31;p= 0.082) and KOOS score (83.60 ± 3.56 vs 81.42 ± 5.07;p= 0.079) between the two groups were found to be insignificant. Meanwhile, the likelihood of requiring meniscus repair increased by 50% for ACLR performed between 6–12 months (OR: 1.50; 95%CI: 0.12–18.57) and increased 3 times for ACLR performed >12 months (OR: 3.00; 95%CI: 0.51–17.60) compared to ACLR performed within 6 months. The likelihood risk of requiring a partial meniscectomy was found to increase by 18 times for ACLR performed between 6–12 months (OR: 18.00; 95%CI: 3.02–107.19) and increased by 19.5 times for ACLR performed >12 months (OR: 19.50; 95%CI: 3.84–84.28).
Conclusion:
ACLR performed >6 months resulted in similar clinical outcomes as an ACLR ≤6 months. However, performing an ACLR >6 months was found to significantly impact the likelihood of developing a meniscus injury and the need for meniscus repair and partial meniscectomy.