title: Delay in ACL reconstruction is associated with more severe and painful meniscal and chondral injuries.
abstract: OBJECTIVE
  The goal of our study was to investigate the associations between surgical delay, pain and meniscus, and articular cartilage lesions seen at the time of ACL reconstruction.
  
  
  METHODS
  One hundred and sixty-two consecutive patients who had received ACL reconstruction were recruited. The preoperative International Knee Documentation Committee (IKDC) questionnaires, and cartilage and meniscal lesions seen at the time of surgery were analysed.
  
  
  RESULTS
  Patients with surgery within 12 months were less likely to have meniscus injury (59.8/77.4 %, p = 0.032), and the meniscus injury was more likely to be salvageable. (56.3/36.0 %, p = 0.042). Patients with meniscal tear larger than 10 mm had higher pain intensity than tear <10 mm (mean 6.8/8.2, p = 0.007). Patients older than 35 years of age were more likely to suffer from cartilage injury (76.4/39.1 %, p = 0.004). Patients with cartilage lesions had longer surgical delay (mean 18.9/12.1 months, p = 0.033). The presence of meniscal tear increased the risk of cartilage lesions (p = 0.038, OR = 2.14). Patients with cartilage lesions had a greater pain frequency (mean 6.9/7.7, p = 0.048). Moderate correlation was found between the size of cartilage lesion and the frequency of pain (p = 0.013).
  
  
  CONCLUSIONS
  Increased surgical delay was associated with an increased incidence of meniscus and articular cartilage injuries in patients suffering from ACL tear; also, the meniscus was less likely to be salvageable. The presence of cartilage lesions was associated with an increased frequency of pain. Size of meniscal and cartilage lesions was significantly associated with pain.
authors.affiliation: Division of Sports and Arthroscopic Surgery, Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, 5/F Professorial Block, Pokfulam, Hong Kong. augustfok@hotmail.com
authors.forename: August W M
authors.initials: AW
authors.lastname: Fok
authors.forename: W P
authors.initials: WP
authors.lastname: Yau
mesh_terms: D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction; D002358:Cartilage, Articular / Q000293:injuries*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D010147:Pain Measurement; D012189:Retrospective Studies; D000070600:Tibial Meniscus Injuries; D061665:Time-to-Treatment