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Early Versus Delayed ACL Reconstruction: Why Delayed Surgery Is Our Preferred Choice

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Controversies in the Technical Aspects of ACL Reconstruction

Abstract

Anterior cruciate ligament (ACL) reconstruction in most cases is an elective surgery with many potential complications. Early (non-emergent) surgery may increase the risk of certain complications including significant postoperative stiffness with loss of motion. Delaying surgery by a few weeks to allow the acutely injured knee to regain motion and gain quad control decreases the risk for these adverse effects. However, delayed ACL reconstruction with the intent of returning to normal activities months after the initial injury may lead to an increased risk of injury to cartilage and menisci. By choosing a delayed surgical treatment pathway, we are not intending to return the patient to sports; rather, we plan to get them through the acute inflammatory phase prior to reconstruction. We know by experience and by numerous well-designed studies that returning a patient with a potentially unstable knee to at risk activities including sports and certain occupations can lead to further injuries with irreversible damage.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Tufts Medical Center, Boston, MA, USA

    Matthew J. Salzler MD

  2. Department of Orthopedics and Traumatology, Acibadem University, Istanbul, Turkey

    Umut Akgün MD & Mustafa Karahan MD

  3. Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA

    Christopher D. Harner MD

Authors
  1. Matthew J. Salzler MD
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  2. Umut Akgün MD
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  3. Mustafa Karahan MD
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  4. Christopher D. Harner MD
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Corresponding author

Correspondence to Christopher D. Harner MD .

Editor information

Editors and Affiliations

  1. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan

    Norimasa Nakamura

  2. Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy

    Stefano Zaffagnini

  3. Hospital for Special Surgery, New York, New York, USA

    Robert G. Marx

  4. UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania, USA

    Volker Musahl

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Salzler, M.J., Akgün, U., Karahan, M., Harner, C.D. (2017). Early Versus Delayed ACL Reconstruction: Why Delayed Surgery Is Our Preferred Choice. In: Nakamura, N., Zaffagnini, S., Marx, R., Musahl, V. (eds) Controversies in the Technical Aspects of ACL Reconstruction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-52742-9_4

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  • DOI: https://doi.org/10.1007/978-3-662-52742-9_4

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-52740-5

  • Online ISBN: 978-3-662-52742-9

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