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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 4, 521-524.
doi: 10.1302/0301-620X.85B4.13743  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Outcome after reconstruction of the anterior cruciate ligament in athletic patients

A COMPARISON OF EARLY VERSUS DELAYED SURGERY

A. A. S. Meighan, FRCS (Trauma & Orth), Knee Fellow; J. F. Keating, FRCS (Trauma & Orth), Consultant Orthopaedic Surgeon; and E. Will, MCSP, Research Physiotherapist

Department of Orthopaedic Trauma, Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3 9YW, UK.

Correspondence should be sent to Mr J. F. Keating.

We randomised 31 patients with acute tears of the anterior cruciate ligament (ACL) to receive either early (within 2 weeks) or delayed (8 to 12 weeks) reconstruction using a quadruple hamstring graft in order to determine if there was any functional advantage to early reconstruction. Outcome measures included return of knee movement, muscle dynamometry, International Knee Documentation Committee (IKDC) scores and Tegner activity levels.

Two cases of symptomatic deep-venous thrombosis occurred in the early group. The mean range of movement was significantly greater at two weeks in the delayed group. Quadriceps muscle power was significantly better in the delayed group at 12 weeks (p < 0.05). These trends were evident at later time points, but were not statistically significant. One patient in each group had clinically significant knee stiffness at 52 weeks. IKDC scores and Tegner activity levels were not significantly different at 52 weeks. We conclude that there is no functional advantage to be gained by early reconstruction of the ACL.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General