Delayed ACL reconstruction may risk meniscal, chondral pathology in adolescent patients
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Key takeaways:
- ACL surgery delayed for more than 4 months was associated with an increased risk of meniscal and chondral pathology in adolescent patients.
- Surgical delays were associated with decreased meniscal repairability.
Results published in the American Journal of Sports Medicine showed surgical delays of more than 4 months may increase the risk of meniscal and chondral injuries in adolescent patients undergoing ACL reconstruction for ACL rupture.
Kirsten L. Hickie, MD, FRCSC, clinical fellow at North Sydney Orthopaedic and Sports Medicine Centre in New South Wales, Australia, and colleagues performed a retrospective analysis of prospectively collected data from 2,740 adolescent patients (median age, 17 years) who underwent ACL reconstruction between January 1993 and April 2023.
Hickie and colleagues found patients with surgical delays of 5 months to 1 year were 1.6 times more likely to have medial meniscal tears requiring surgery, while patients with surgical of delays of more than 1 year were 4.2 times more likely to have medial meniscal tears requiring surgery and 3.4 times more likely to have medial chondral injuries.
In addition, Hickie and colleagues found surgical delays were associated with decreased repairability of medial and lateral meniscal tears. They noted patients aged 14 to 19 years were more likely to undergo meniscus surgery and more likely to have chondral pathology compared with patients younger than 14 years (45% vs. 30%, respectively).
“Timely diagnosis of ACL injury and early surgical referral are important for reducing the odds of meniscal and chondral pathology in adolescents,” Hickie and colleagues wrote in the study. “The prevalence of secondary meniscal and chondral injury remained relatively stable between 0 and 4 months, so we suggest that ACL reconstruction in adolescents should be planned for this window where possible.”
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