There appears to be a strong association between time to surgery and the incidence of irreparable meniscus pathology. We recommend that the ACL be reconstructed within 12 weeks of injury.”—Jason Akindolire, BSc.
Akindolire and colleagues in London, Ontario, Canada, compared outcomes among patients with similar baseline status, age, and who were treated at 2 medical centers in Canada. The retrospective analysis included 156 patients (median age 18 at injury) with a median time of 40 weeks from injury to surgery treated at one center, and 161 patients (median age 21 at injury) with a median time of 4.4 weeks from injury to surgery treated at another.According to the researchers, the centers “were similar in demographics and practice patterns, yet different in terms of their capacity to expedite care. …There appears to be a strong association between time to surgery and the incidence of irreparable meniscus pathology. We recommend that the ACL be reconstructed within 12 weeks of injury,” Akindolire said.
The sooner, the better
Patients at the speedier medical center did remarkably better—they were nearly twice as likely to have a repairable tear at surgery (OR 1.780, 95% CI 1.140-2.779).
The best chances for meniscus repair were associated with the earliest surgical interventions. Patients who had surgery within 26 weeks of injury were 1.7 times more likely to have repairable meniscal pathology than those whose ACL reconstructions were delayed >26 weeks. Those who had ACL repair <12 weeks after injury were 2.6 times more likely to have repairable meniscal pathology than those operated on >12 weeks.
The researchers concluded that their analysis confirms the relationship between swift surgical timing and the possibility for repairing meniscal damage after ACL injury.
Reference
1. Akindolire J, Willits K, Shelton WR, et al. The effect of surgical timing on meniscal reparability during ACL reconstruction. Presented at: AAOS 2008 meeting; March 5, 2008; San Francisco, Calif. Presentation 045.
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