Optimal reconstruction timing of partially injured anterior cruciate ligaments on postoperative knee functions
WANG Yang
BAI Lun-hao
LI Bin
ZHOU Bing-zheng
Abstract：Objective To explore the optimal timing for arthroscopic surgery of partially injured anterior cruciate ligaments ( ACL ). Methods Cases were classified based on the time interval between injury and surgery: early surgery group ( < 3 weeks, n = 32 ), delayed surgery group ( > 3 weeks, n = 45 ). International Knee Documentation Committee ( IKDC ) score, Lysholm knee score, Tegner activity rating, knee range of motion ( ROM ), and Kneelax arthrometer were applied to measure the changes of ROM and stability before and after surgery. Results Minimum follow-up was 2 years, average of 27 months. Knee stability assessed by Kneelax arthrometer ( 30° flexion and 132 N ): ( 1.0 ± 0.9 ) mm in early surgery group and ( 2.3 ± 1.5 ) mm in delayed surgery group ( P < 0.01 ). The stability results indicated that patients in the early surgery group had significantly less anterior displacement than patients in the delayed surgery group 2 years postoperatively. With regard to associated injuries, 2 patients had medial meniscus rupture and 3 had lateral meniscus rupture in the early surgery group. While in the delayed surgery group:4 patients had medial meniscus rupture and cartilage injury, 5 had lateral meniscus rupture and cartilage injury, 5 had medial and lateral meniscus rupture and cartilage injury, 5 had simple medial meniscus rupture. It demonstrated that associated injuries in early surgery patients were significantly fewer than in the delayed surgery group ( P = 0.036 ). The mean range of motion were ( 120.6 ± 9.9 ) ° and ( 132.4 ± 13.2 ) ° ( P = 0.452 ), mean Lysholm scores ( 94.7 ± 9.3 ) point and ( 92.2 ± 7.8 ) point ( P = 0.332 ), mean Tegner scores ( 7.1 ± 1.2 ) point and ( 6.3 ± 1.8 ) point ( P = 0.935 )in the early and delayed surgery group. In terms of the IKDC evaluation system, 30 out of 32 ( 93.75% ) patients in the early surgery group and 43 out of 45 ( 95.56% ) patients in the delayed surgery group were graded as normal or nearly normal ( P = 0.976 ). No statistical significance existed between the 2 groups with respect to the 4 types of assessment results ( P > 0.05 ). Conclusions Early surgical reconstruction of partially ruptured ACLs will not result in arthrofbrosis but may prevent secondary loosening of the intact bundles and further meniscal and chondral injury.
Keywords：MeniscitibiaAnterior cruciate ligament reconstructionArthroscopyHospitalsconvalescent
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 140-144 )