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The incidence of secondary pathology after anterior cruciate ligament rupture in 5086 patients requiring ligament reconstruction.
MedLine Citation:
PMID:  23307674     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
We reviewed 5086 patients with a mean age of 30 years (9 to 69) undergoing primary reconstruction of the anterior cruciate ligament (ACL) in order to determine the incidence of secondary pathology with respect to the time between injury and reconstruction. There was an increasing incidence of medial meniscal tears and chondral damage, but not lateral meniscal tears, with increasing intervals before surgery. The chances of requiring medial meniscal surgery was increased by a factor of two if ACL reconstruction was delayed more than five months, and increased by a factor of six if surgery was delayed by > 12 months. The effect of delaying surgery on medial meniscal injury was also pronounced in the patients aged < 17 years, where a delay of five to 12 months doubled the odds of medial meniscal surgery (odds ratio (OR) 2.0, p = 0.001) and a delay of > 12 months quadrupled the odds (OR 4.3, p = 0.001). Increasing age was associated with a greater odds of chondral damage (OR 4.6, p = 0.001) and medial meniscal injury (OR 2.9, p = 0.001), but not lateral meniscal injury. The gender split (3251 men, 1835 women) revealed that males had a greater incidence of both lateral (34% (n = 1114) vs 20% (n = 364), p = 0.001) and medial meniscal tears (28% (n = 924) vs 25% (n = 457), p = 0.006), but not chondral damage (35% (n = 1152) vs 36% (n = 665), p = 0.565). We conclude that ideally, and particularly in younger patients, ACL reconstruction should not be delayed more than five months from injury.Cite this article: Bone Joint J 2013;95-B:59-64.
Authors:
K Sri-Ram; L J Salmon; L A Pinczewski; J P Roe
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bone & joint journal     Volume:  95-B     ISSN:  2049-4408     ISO Abbreviation:  Bone Joint J     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101599229     Medline TA:  Bone Joint J     Country:  England    
Other Details:
Languages:  eng     Pagination:  59-64     Citation Subset:  AIM; IM    
Affiliation:
North Sydney Orthopaedic and Sports Medicine Centre, The Mater Clinic, Suite 2, 3 Gillies St, Wollstonecraft, Sydney 2010, New South Wales, Australia.
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