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Delayed ACL reconstruction linked to negative impact on activities of daily living in young patients
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LYON, France — In a retrospective cohort study of adolescent patients who underwent ACL reconstruction, findings linked surgical delay with lower scores for activities of daily living and greater rates of specific associated tears and lesions.
“This study has shown that long surgical delay has a negative impact on the activity of daily living outcome score. Long surgical delays have been associated with a high incidence of medial meniscal tears and lateral femoral condyle cartilage lesions,” Guy Grimard, MD, said in his presentation at the International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Biennial Congress, here.
Grimard and colleagues reviewed the clinical records of 50 patients with a minimum 2-year follow-up who met study inclusion criteria and sent them a KOOS questionnaire to determine whether delayed reconstruction impacted the patients’ quality of life and whether the delay was associated with meniscus and cartilage injuries. The mean age of the patients at follow-up was 20.5 years, and the mean follow-up time was 58 months. The mean delay between injury and surgery was 18 months, and the ratio of female to male patients was 4:1. Overall, 29 patients completed the questionnaire.
“The mean follow-up time was significantly different between the whole cohort vs. the responding participants,” Grimard said.
The researchers found the medial and lateral menisci were torn in 58% of patients, and that complex meniscal tears were more common on the medial side. In addition, lateral meniscus tears were more prone to undergo partial meniscectomy.
“There was a significant statistical association between surgical delay and the severity of the medial meniscal tear and the lateral femoral condyle cartilage damage,” Grimard said. “Among the five domains of the KOOS score, two domains were associated with the severity of injury found at the time of surgery. KOOS pain and KOOS ADL [activities of daily living] were associated with chondral damage.” – by Gina Brockenbrough, MA
Reference:
Nault ML, et al. Paper #205. Presented at: International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial Congress; June 11, 2015; Lyon, France.
Disclosure: Grimard reports he is an unpaid consultant for and has stock in EMOVI.