ACL Reconstruction: Is Delaying Surgery Really Better?
"A new study questions the long-held belief that delaying ACL reconstruction leads to better outcomes, challenging conventional wisdom in sports medicine."
Anterior cruciate ligament (ACL) injuries are a common and often devastating occurrence for athletes and active individuals. For years, the standard approach has been to delay surgical reconstruction of the ACL to allow for swelling to subside and range of motion to return. This approach was rooted in the belief that operating on an inflamed knee could lead to stiffness and other complications.
However, recent research is beginning to challenge this conventional wisdom. A study presented at the 2016 Combined Australian Knee Society and New Zealand Knee & Sport Society Meeting investigated whether there were significant differences in outcomes between patients who underwent acute (early) ACL reconstruction versus those who had delayed surgery. The results may surprise you.
This article delves into the key findings of this study, exploring the implications for athletes, active individuals, and the orthopedic surgeons who treat them. We'll break down the research in an easy-to-understand way, providing insights into whether delaying ACL reconstruction is truly the best course of action.
Challenging the Status Quo: Acute vs. Delayed Reconstruction
The study, titled "Results Are Similar Two Years After Acute or Delayed Anterior Cruciate Ligament Reconstruction. A Randomized Controlled Trial," aimed to assess the impact of the timing of ACL reconstruction on patient outcomes. Researchers randomized 70 patients with acute ACL injuries, all with a high recreational activity level (Tegner ≥6), into two groups: one undergoing acute reconstruction within 8 days of the injury, and the other undergoing delayed reconstruction 6-10 weeks after the injury, once normalized ROM was achieved.
- Lysholm score
- KOOS values
- VAS scores (measuring knee function and impact on activity level)
- Functional strength (one leg hop index >90%)
Rethinking ACL Reconstruction Timelines
The study's conclusion is particularly noteworthy: "We found no increased risk of arthrofibrosis after acute ACLR. Good results can be achieved at two years regardless of ROM and swelling in the acute stage." This challenges the traditional approach of delaying surgery and suggests that early reconstruction may be a viable option for many patients. While further research is always warranted, these findings provide valuable insights for athletes, active individuals, and orthopedic surgeons alike, potentially paving the way for more individualized treatment plans.