Quick recovery and no arthrofibrosis in acute anterior cruciate ligament reconstruction. A prospective trial of early versus delayed reconstruction

Background. Anterior cruciate ligaments tears is one of the most frequent orthopae- dics and sports medicine injuries in the athletically active population and timing of reconstruction represents a debated topic. The aim of the study is to compare range of motion (ROM) recovery and clinical outcomes between patients operated for acute reconstruction (maximum 2 weeks injury-surgery interval) and delayed reconstruction (minimum 3 weeks injury-surgery interval). Methods. A total of 52 patients were prospectively involved in the study. 26 patients underwent acute reconstruction and 26 delayed reconstruction. A standard physical examination with Lachman and Pivot shift test and a passive ROM measurement with a goniometer were performed at each follow-up (2, 4, 8, 12 and 24 weeks postoper- atively). Clinical outcomes were measured at final follow-up using Knee Injury and Osteoarthritis outcome score (KOOS), Tegner Lysholm Score and International Knee Documentation Committe (IKDC 2000) and KT-1000 evaluation. Single-leg hop test and thigh circumference measurement were performed at final follow-up. Results. Both groups showed no statistically significant differences regarding the ROM. Full ROM was achieved 12 weeks after surgery in both groups. The mean IKDC was 98.7 and 95.2; the mean Tegner Lysholm was 100 and 93.8 and the mean KOOS was 99 and 95.5 in the acute group and delayed ACLR group respectively. Conclusions. There were no differences between acute and delayed anterior cruci- ate ligament reconstruction regarding the risk of arthrofibrosis and clinical outcomes. Acute reconstruction can be performed safely with no increased risk of arthrofibrosis.