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Early versus delayed surgery for anterior cruciate ligament reconstruction: a systematic review and meta-analysis

Knee Surgery, Sports Traumatology, Arthroscopy volume 18, pages 304–311 (2010)Cite this article

Abstract

There is no consensus in the literature regarding the optimal timing of surgical reconstruction of the ruptured anterior cruciate ligament (ACL). Previous authors have suggested that early reconstruction may facilitate an early return to work or sport but may increase the incidence of post-operative complications such as arthrofibrosis. This study systematically reviewed the literature to determine whether ACL reconstruction should be performed acutely following rupture. Medline, CINAHL, AMED, EMBASE databases and grey literature were reviewed with a meta-analysis of pooled mean differences where appropriate. Six papers including 370 ACL reconstructions were included. Early ACL reconstructions were considered as those undertaken within a mean of 3 weeks post-injury; delayed ACL reconstructions were those undertaken a minimum of 6 weeks post-injury. We found there was no difference in clinical outcome between patients who underwent early compared to delayed ACL reconstruction. However, this conclusion is based on the current literature which has substantial methodological limitations.

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Acknowledgments

We thank the Sir Thomas Browne Library at the Norfolk and Norwich University Hospital for their assistance in gathering the articles which formed the basis of this paper.

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Authors and Affiliations

  1. Institute of Orthopaedics, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk, NR2 7UY, UK

    Toby O. Smith

  2. University of East Anglia, Norwich, UK

    Toby O. Smith

  3. Physiotherapy Department, Norfolk and Norwich University Hospital, Norwich, UK

    Leigh Davies

  4. Watford General Hospital, Watford, UK

    Caroline B. Hing

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Correspondence to Toby O. Smith.

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Smith, T.O., Davies, L. & Hing, C.B. Early versus delayed surgery for anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 18, 304–311 (2010). https://doi.org/10.1007/s00167-009-0965-z

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