PMID- 34739960
OWN - NLM
STAT- MEDLINE
DCOM- 20211207
LR  - 20211214
IS  - 1873-5800 (Electronic)
IS  - 0968-0160 (Linking)
VI  - 33
DP  - 2021 Dec
TI  - Delaying ACL reconstruction beyond 6 months from injury impacts likelihood for 
      clinically significant outcome improvement.
PG  - 290-297
LID - S0968-0160(21)00252-0 [pii]
LID - 10.1016/j.knee.2021.10.010 [doi]
AB  - BACKGROUND: The effect of surgical latency on outcomes of anterior cruciate 
      ligament reconstruction (ACLR) is a topic that is heavily debated. Some studies 
      report increased benefit when time from injury to surgery is decreased while 
      other studies report no benefit. The purpose of our analysis was to compare 
      achievement of clinically significant outcomes (CSOs) in patients with greater 
      than six months of time from injury to ACLR to those with less than or equal to 
      six months of time to surgery. METHODS: Patients undergoing primary ACLR between 
      January 2017 and January 2018 with minimum one year follow-up were included. 
      International Knee Documentation Committee (IKDC) score and Knee Injury and 
      Osteoarthritis Outcomes Score (KOOS) were collected. Multivariate logistic 
      regression was performed for outcome achievement and risk of revision ACLR and 
      Weibull parametric survival analysis was performed for relative time to outcome 
      achievement. The level of significance was set at alpha = 0.05. RESULTS: 379 patients 
      were included of which, 140 patients sustained ACL injury greater than six months 
      prior to surgery. This group of patients experienced reduced likelihood to 
      achieve patient-acceptable symptomatic state (PASS) on the IKDC (p = 0.03), KOOS 
      Pain (p = 0.01) and a greater likelihood to undergo revision ACLR (p = 0.001). 
      There was no impact of surgical timing on minimal clinically important difference 
      (MCID). CONCLUSION: Patients with greater than 6 months from injury to ACLR 
      reported reduced likelihood to achieve CSOs, delayed achievement of CSOs, and 
      increased rates of revision surgery.
CI  - Copyright (c) 2021 Elsevier B.V. All rights reserved.
FAU - Forsythe, Brian
AU  - Forsythe B
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA. 
      Electronic address: forsythe.research@rushortho.com.
FAU - Lu, Yining
AU  - Lu Y
AD  - Dept. of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA.
FAU - Agarwalla, Avinesh
AU  - Agarwalla A
AD  - Dept. of Orthopaedic Surgery, Westchester Medical Center, Valhalla, NY, USA.
FAU - Ezuma, Chimere O
AU  - Ezuma CO
AD  - School of Medicine, Vagelos Columbia College of Physicians and Surgeons, New 
      York, NY, USA.
FAU - Patel, Bhavik H
AU  - Patel BH
AD  - Dept. of Orthopaedic Surgery, University of Illinois - Chicago, Chicago, IL, USA.
FAU - Nwachukwu, Benedict U
AU  - Nwachukwu BU
AD  - Dept. of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
FAU - Beletsky, Alexander
AU  - Beletsky A
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
FAU - Chahla, Jorge
AU  - Chahla J
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
FAU - Kym, Craig R
AU  - Kym CR
AD  - Dept. of Orthopaedic Surgery, University of Illinois - Chicago, Chicago, IL, USA.
FAU - Yanke, Adam B
AU  - Yanke AB
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
FAU - Cole, Brian J
AU  - Cole BJ
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
FAU - Bush-Joseph, Charles A
AU  - Bush-Joseph CA
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
FAU - Bach, Bernard R
AU  - Bach BR
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
FAU - Verma, Nikhil N
AU  - Verma NN
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
LA  - eng
PT  - Journal Article
DEP - 20211030
PL  - Netherlands
TA  - Knee
JT  - The Knee
JID - 9430798
SB  - IM
MH  - *Anterior Cruciate Ligament Injuries/surgery
MH  - *Anterior Cruciate Ligament Reconstruction
MH  - Cohort Studies
MH  - Humans
MH  - Knee Joint/surgery
MH  - Reoperation
OTO - NOTNLM
OT  - ACL
OT  - Anterior cruciate ligament
OT  - Anterior cruciate ligament reconstruction
OT  - Clinically significant outcomes
OT  - Patient reported outcome measures
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2021/11/06 06:00
MHDA- 2021/12/15 06:00
CRDT- 2021/11/05 20:12
PHST- 2021/04/02 00:00 [received]
PHST- 2021/10/05 00:00 [revised]
PHST- 2021/10/07 00:00 [accepted]
PHST- 2021/11/06 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/11/05 20:12 [entrez]
AID - S0968-0160(21)00252-0 [pii]
AID - 10.1016/j.knee.2021.10.010 [doi]
PST - ppublish
SO  - Knee. 2021 Dec;33:290-297. doi: 10.1016/j.knee.2021.10.010. Epub 2021 Oct 30.