Pre-operative Joint Inflammation has no Bearing on Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction at 1-Year Follow-Up; a Prospective Study.

Abstract

To study the effect of pre-operative joint inflammation on clinical outcome at 1year follow-up following ACL reconstruction surgery. Male patients, aged 18-40years, suffering from isolated ACL injury were included. All patients were randomly divided into two groups based on the type of graft used: Group A: semitendinosus gracilis graft with preserved insertions (STG-PI), Group B: bone-patellar tendon-bone graft (BPTB). Patients were categorised based on the time of presentation after injury: (a) within 6weeks of injury, (b) between 6 and 12weeks of injury, (c) after 12weeks of injury. Synovial fluid levels of Interlukin-1, Interlukin-6 and TNF-α were measured in all the ACL deficient knees by taking a joint fluid sample intra-operatively. The total number of patients in the study was 59; 23 in group A (STG-PI) and 36 in group B (BPTB). Mean age of patients was 26 ± 5.146years. 14 out of 59 (23.7%) patients presented within 6weeks of injury, 16 (27.11%) patients presented between 6 and 12weeks after injury and 29 (49.1%) patients presented after 12weeks of injury. IL-6 levels were significantly high in group with < 6weeks of injury than in group with > 12weeks since injury. IL-6 had significant correlation with VAS scores, KT 1000, Lysholm knee scores and Tegner level of activity. There was no difference in outcome (pain scores, mechanical stability, Lysholm knee score and Tegner level of activity) at 1year follow-up when patients with different time intervals since injury were compared. The clinical outcome in terms of pain score, mechanical stability, functional scores and return to sporting activity is comparable, irrespective of the time since injury, at short term follow-up.