Does delay in Acl reconstruction increases incidence of associated injuries?

Abstract

Background and objective: Anterior cruciate ligament (ACL) rupture is the most common among young population involved in sports activates. In previous literature it is evident that delay in reconstruction results in increased incidence of meniscal injury and degenerative changes due to knee instability. The aim of this study is to find out incidence of meniscal injury and cartilage damage in ACL deficient knee and weather the incidence is more in chronic ACL deficient knee. Methods: All cases of ACL reconstruction done in our institution during 2011 to 2015 were included in study. Patients above 50 years were excluded. The case records reviewed and data collected. The time period between primary injury and surgery noted along with findings in diagnostic arthroscopy. The cases were divided as per the times when surgery was done after primary injury in to two groups as early reconstruction group (Group A) and late reconstruction group (Group B). The associated injuries of meniscus and cartilage damage were noted in both groups. Results: After considering inclusion and exclusion criteria 113 patient were included in study. 65 patients were in Group A and 48 patients in Group B. 36 patients (74%) in Group B and 23 patients (25%) in Group had meniscal injury. It was observed that Group B had high incidence of medial meniscal injury compared to Group A. four patients in Group B had chondral damage compared to one patient in Group A. Conclusion: Incidence of medial meniscus injury and both meniscus injury was found to be more in late reconstruction group. Chondral damage also is more in late reconstruction group. Delay in ACL reconstruction results in early onset of degenerative changes and meniscal injury. We recommend early reconstruction of ACL preferably within three months. Keywords: Ligament, Meniscus, Chondral defect, Hamstring graft.