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Delay in surgery predisposes to meniscal and chondral injuries in anterior cruciate ligament deficient knees

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Abstract

Background: Despite improvements in instability after anterior cruciate ligament (ACL) reconstruction, associated intraarticular injuries remain a major cause of concern and important prognostic factor for long term results as it may lead to osteoarthritis. Delay in ACL reconstruction has been in variably linked to increase in these injuries but there is lack of consensus regarding optimal timing of reconstruction. The goal of this study was to investigate delay in surgery and other factors, associated with intraarticular injuries in ACL deficient knees.

Materials and Methods: A total of 438 patients (42 females; 396 males) enrolled forthis prospective observational study. The average age of patients was 26.43 (range 17–51 years) years with a mean surgical delay of 78.91 (range 1 week – 18 years) weeks after injury. We analyzed the factors of age, sex, surgical delay, instability, and level of activity for possible association with intraarticular injuries.

Results: Medial meniscus injuries had a significant association with surgical delay (P = 0.000) after a delay of 6 months. Lateral meniscus injuries had a significant association with degree of instability (P = 0.001). Medial-sided articular injuries were significantly affected by age (0.005) with an odds ratio (OR) of 1.048 (95% confidence interval [CI] of 1.014–1.082) reflecting 4.8% rise in incidence with each year. Lateral-sided injuries were associated with female sex (P = 0.018) with OR of 2.846 (95% CI of 1.200–6.752). The level of activity failed to reveal any significant associations.

Conclusion: Surgical delay predicts an increase in medial meniscal and lateral articular injuries justifying early rather than delayed reconstruction in ACL deficient knees. Increasing age is positively related to intraarticular injuries while females are more susceptible to lateral articular injuries.

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Authors and Affiliations

  1. Department of Orthopaedics, Government Medical College and Hospital, Sector 32, Chandigarh, 160 030, India

    Ravi Gupta, Gladson David Masih, Gaurav Chander &  Vikas Bachhal

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  1. Ravi Gupta
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  2. Gladson David Masih
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  3. Gaurav Chander
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  4. Vikas Bachhal
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Correspondence to Vikas Bachhal.

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This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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Gupta, R., Masih, G.D., Chander, G. et al. Delay in surgery predisposes to meniscal and chondral injuries in anterior cruciate ligament deficient knees. IJOO 50, 492–498 (2016). https://doi.org/10.4103/0019-5413.189606

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