A review of early anterior cruciate ligament surgical repair or reconstruction. Results and caveats.
Earlier diagnosis and knowledge of the natural history of anterior cruciate ligament (ACL) injuries has made consideration of early operative treatment more important in the active patient at risk for further instability episodes. In a review of early operative treatment options, ACL repair alone has been disappointing for many patients, with long-term follow-up suggesting that the reinjury rate is high. Early repair with augmentation or reconstruction with hamstring or central third bone-tendon-bone graft yielded better results, but long-term follow-up is still needed, especially in the early reconstruction groups. Early ACL reconstruction, especially in patients with medial collateral ligament injury and/or extra-articular surgery, is associated with an increased incidence of arthrofibrosis. The methods of reporting data in these studies have also presented problems in interpreting and comparing data from one study with those of another. Further standardization will be needed if literature regarding ACL surgery can be easily compared from series to series.
Nogalski
M P
MP
Department of Orthopaedic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.
Bach
B R
BR
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001168:Arthritis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D016025:Bone Transplantation; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009132:Muscles / Q000637:transplantation; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D019736:Prostheses and Implants; D016059:Range of Motion, Articular; D012008:Recurrence; D012307:Risk Factors; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology