Acl Reconstruction - It's All About Timing

Overview

Journal Int J Sports Phys Ther

Specialty Rehabilitation Medicine

Date 2014 May 3

PMID 24790787

Citations 29

Authors

Stephanie Evans

Justin Shaginaw

Arthur Bartolozzi

Affiliations

Soon will be listed here.

Abstract

Injury to the anterior cruciate ligament (ACL) is the most common ligamentous injury, ranging from up to 200,000 injuries per year in the United States. Sports such as soccer, football, and skiing have been reported to be high-risk sports that can cause injury to the ACL when compared to other sport activities. Due to the high incidence of ACL injuries, approximately 100,000 ACL reconstructions are performed each year. Although conservative treatment can potentially be successful in the appropriate population, patients with goals of returning to high levels of sport activity may not be successful with conservative treatment. Even though reconstruction is the most common treatment for ACL rupture, there remains debate in the literature regarding the optimal timing of surgery. Therefore, the purpose of this clinical commentary is to review the available evidence to provide insight into the optimal timing of ACL reconstruction.

Citing Articles

Integrating Modern Technologies into Traditional Anterior Cruciate Ligament Tissue Engineering.

Sopilidis A, Stamatopoulos V, Giannatos V, Taraviras G, Panagopoulos A, Taraviras S Bioengineering (Basel). 2025; 12(1).

PMID: 39851313 PMC: 11762506. DOI: 10.3390/bioengineering12010039.

How Can the Environmental Impact of Orthopaedic Surgery Be Measured and Reduced? Using Anterior Cruciate Ligament Reconstruction as a Test Case.

Silva de Souza Lima Cano N, Engler I, Mohammadiziazi R, Geremicca F, Lawson D, Drain N Clin Orthop Relat Res. 2024; 483(1):7-19.

PMID: 39660662 PMC: 11658741. DOI: 10.1097/CORR.0000000000003242.

Ligamental reconstruction improved the functional outcomes of patients with anterior cruciate ligament injury and early-stage symptomless osteoarthritis.

Liu G, Chen X, Jin Y, Liu X, Wu S, Xiong H BMC Musculoskelet Disord. 2024; 25(1):958.

PMID: 39587577 PMC: 11590315. DOI: 10.1186/s12891-024-08102-9.

Osteoarthritis After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Contributing Factors and Potential Treatments.

Charles S, Preston N Cureus. 2024; 16(10):e71188.

PMID: 39525184 PMC: 11549666. DOI: 10.7759/cureus.71188.

Anterior Cruciate Ligament Tear: Individualized Indications for Non-Operative Management.

Komnos G, Hantes M, Kalifis G, Gkekas N, Hante A, Menetrey J J Clin Med. 2024; 13(20).

PMID: 39458183 PMC: 11508887. DOI: 10.3390/jcm13206233.

References

Adams D, Logerstedt D, Hunter-Giordano A, Axe M, Snyder-Mackler L . Current concepts for anterior cruciate ligament reconstruction: a criterion-based rehabilitation progression. J Orthop Sports Phys Ther. 2012; 42(7):601-14. PMC: 3576892. DOI: 10.2519/jospt.2012.3871. View

Church S, Keating J . Reconstruction of the anterior cruciate ligament: timing of surgery and the incidence of meniscal tears and degenerative change. J Bone Joint Surg Br. 2005; 87(12):1639-42. DOI: 10.1302/0301-620X.87B12.16916. View

Bottoni C, Liddell T, Trainor T, Freccero D, Lindell K . 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. 2008; 36(4):656-62. DOI: 10.1177/0363546507312164. View

Wittenberg R, Oxfort H, Plafki C . A comparison of conservative and delayed surgical treatment of anterior cruciate ligament ruptures. A matched pair analysis. Int Orthop. 1998; 22(3):145-8. PMC: 3619588. DOI: 10.1007/s002640050228. View

Meighan A, Keating J, Will E . Outcome after reconstruction of the anterior cruciate ligament in athletic patients. A comparison of early versus delayed surgery. J Bone Joint Surg Br. 2003; 85(4):521-4. DOI: 10.1302/0301-620x.85b4.13743. View

Anstey D, Heyworth B, Price M, Gill T . Effect of timing of ACL reconstruction in surgery and development of meniscal and chondral lesions. Phys Sportsmed. 2012; 40(1):36-40. DOI: 10.3810/psm.2012.02.1949. View

Gwinn D, Wilckens J, McDevitt E, Ross G, KAO T . The relative incidence of anterior cruciate ligament injury in men and women at the United States Naval Academy. Am J Sports Med. 2000; 28(1):98-102. DOI: 10.1177/03635465000280012901. View

Smith T, Davies L, Hing C . Early versus delayed surgery for anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2009; 18(3):304-11. DOI: 10.1007/s00167-009-0965-z. View

Hughes G, Watkins J . A risk-factor model for anterior cruciate ligament injury. Sports Med. 2006; 36(5):411-28. DOI: 10.2165/00007256-200636050-00004. View

10.

Ahlen M, Liden M . A comparison of the clinical outcome after anterior cruciate ligament reconstruction using a hamstring tendon autograft with special emphasis on the timing of the reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010; 19(3):488-94. DOI: 10.1007/s00167-010-1312-0. View

11.

Harvey A, Thomas N, Amis A . Fixation of the graft in reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br. 2005; 87(5):593-603. DOI: 10.1302/0301-620X.87B5.15803. View

12.

Passler J, Schippinger G, Schweighofer F, Fellinger M, Seibert F . [Complications in 283 cruciate ligament replacement operations with free patellar tendon transplantation. Modification by surgical technique and surgery timing]. Unfallchirurgie. 1995; 21(5):240-6. DOI: 10.1007/BF02588763. View

13.

Demirag B, Aydemir F, Danis M, Ermutlu C . Incidence of meniscal and osteochondral lesions in patients undergoing delayed anterior cruciate ligament reconstruction. Acta Orthop Traumatol Turc. 2011; 45(5):348-52. DOI: 10.3944/AOTT.2011.2398. View

14.

Shultz S, Schmitz R, Benjaminse A, Chaudhari A, Collins M, Padua D . ACL Research Retreat VI: an update on ACL injury risk and prevention. J Athl Train. 2012; 47(5):591-603. PMC: 3465040. DOI: 10.4085/1062-6050-47.5.13. View

15.

Granan L, Bahr R, Lie S, Engebretsen L . Timing of anterior cruciate ligament reconstructive surgery and risk of cartilage lesions and meniscal tears: a cohort study based on the Norwegian National Knee Ligament Registry. Am J Sports Med. 2009; 37(5):955-61. DOI: 10.1177/0363546508330136. View

16.

Shelbourne K, Patel D . Timing of surgery in anterior cruciate ligament-injured knees. Knee Surg Sports Traumatol Arthrosc. 1995; 3(3):148-56. DOI: 10.1007/BF01565474. View

17.

Shelbourne K, Wilckens J, Mollabashy A, Decarlo M . Arthrofibrosis in acute anterior cruciate ligament reconstruction. The effect of timing of reconstruction and rehabilitation. Am J Sports Med. 1991; 19(4):332-6. DOI: 10.1177/036354659101900402. View

18.

Frobell R, Roos E, Roos H, Ranstam J, Lohmander L . A randomized trial of treatment for acute anterior cruciate ligament tears. N Engl J Med. 2010; 363(4):331-42. DOI: 10.1056/NEJMoa0907797. View

19.

Dragoo J, Braun H, Durham J, Chen M, Harris A . Incidence and risk factors for injuries to the anterior cruciate ligament in National Collegiate Athletic Association football: data from the 2004-2005 through 2008-2009 National Collegiate Athletic Association Injury Surveillance System. Am J Sports Med. 2012; 40(5):990-5. DOI: 10.1177/0363546512442336. View

20.

Almekinders L, Moore T, Freedman D, Taft T . Post-operative problems following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 1995; 3(2):78-82. DOI: 10.1007/BF01552379. View