Timing of surgery of the anterior cruciate ligament.
OBJECTIVE
We aimed to perform a systematic review of the literature concerned with timing of surgery after anterior cruciate ligament injury.


METHODS
A systematic electronic search in Medline through PubMed, Embase, and the Cochrane Library was carried out in October 2011. All English-language randomized controlled clinical trials, prospective comparative cohort studies, and prognostic and diagnostic studies published from January 1995 to August 2011 were eligible for inclusion. All articles addressing timing of surgery were eligible for inclusion regardless of injury-to-surgery interval, graft type, surgical technique, or rehabilitation. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guided the reporting and data abstraction. Methodologic quality of all included articles was carefully assessed.


RESULTS
We included 22 articles (3,583 patients) in the systematic review. Study design, research methodology, surgical technique, and outcome measurements differed greatly among included articles. The injury-to-surgery interval, classified as early and delayed, ranged from within 2 days to 7 months and 3 weeks to 24 years, respectively. Eight articles promoted early reconstruction, whereas the majority of articles found no difference in outcome between early and delayed surgery. Two articles were inconclusive.


CONCLUSIONS
There were few or no differences in subjective and objective outcomes related to timing of anterior cruciate ligament reconstruction.


METHODS
Level II, systematic review of Level I and II studies.
Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden. Electronic address: daniel.andernord@gmail.com.
Daniel
D
Andernord
Jón
J
Karlsson
Volker
V
Musahl
Mohit
M
Bhandari
Freddie H
FH
Fu
Kristian
K
Samuelsson
D006801:Humans; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods; D019317:Evidence-Based Medicine; D007718:Knee Injuries / Q000534:rehabilitation / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D011446:Prospective Studies; D055502:Secondary Prevention; D013997:Time Factors