Rokas Jurkonis, Rimtautas Gudas
Abstract
Purpose: the aim of this study is to determine do the time factor have influence on recovery results after ACL-R in line with other patient related factors. There are hypotheses as follow: 1. Early ACL-R have lower the postoperative laxity difference measured. 2. Incidence of meniscal tears and chondral degenerative changes increase in late ACL-R. Material and methods. 207 consecutive patients were analysed, who underwent reconstruction of anterior cruciate ligament between January 2014 and January 2016. Patients were divided into three groups according to the time from injury to surgery (≤3 months, 3.1 – 12 months, and > 12 months to surgery). ACLR surgery using a quadrupled hamstring strand, single- bundle autograft was performed for all patients. Follow-up examinations were performed at 3, 6 and 12 months postoperatively. At all follow-up visits laximetric measurement were performed using GNRB® (GeNouRoB, France). A “residual laxity” of the ACLR was defined by a differential laximetric of greater than 3 mm at 134 N (Δ134 > 3 mm). Results. 207 patient evaluated, there were 53 (25.6%) men and 154 (74.4%) women with the mean age 33.21 ± 9.78 years (range 18 – 55), and median is 33 years. The mean time from injury to surgery was 17.66 (35.66) months, median 4.5 months. There was a significant difference in the incidence of meniscal tears between patients treated in the early group (13 (18.3%)) and in those underwent ACL-R after 12 months (25 (46.3%)), (P < 0.001). The examination of possible risk factors for medial meniscus tear revealed, that BMI (overweight) (OR=2.04; 95% CI=1.091-3.814) and time from injury to surgery (weeks) (OR=1.026; 95% CI=1.012-1.04) significantly increased possibility of medial meniscus tear. We found no significant laxity difference between postoperative testings’ (3, 6 and 12 months after surgery) and the three groups, created by the time to surgery. Conclusion. The study revealed a significant difference in the incidence of meniscal tears between patients treated in the early group and in those underwent ACL-R after 12 months, which lead to significantly higher chance (every delayed week increase chance by 1.026 times and overweight (BMI ≥ 25 kg/ m2) increase chance by 2.04 times) of a medial meniscal tear occurring in patients undergoing delayed reconstruction.
Keyword(s): anterior cruciate ligament reconstruction; time to surgery; GNRB®; residual laxity.
DOI: 10.5200/sm-hs.2017.036
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