Meniscal and chondral injuries associated with surgical delay before anterior cruciate ligament reconstruction in adolescents

ObjectivesA delay before anterior cruciateligament reconstruction (ACLR) is known to have an impact on meniscal and cartilage injury severity at the time of surgery, which can lead to lower quality of life. The main objective of this study was to assess the impact of surgical delay on quality of life in an ACLR adolescent population. The secondary objective was to evaluate its effects on meniscus and cartilage injuries at the time of surgery.MethodsThis study was conducted in a tertiary paediatric hospital. All ACLR cases performed between January 2004 and December 2011 were retrieved from hospital databases. Medical records were reviewed to collect the following information: demographics, Body Mass Index, age at time of injury, surgical delay and operative findings (meniscus and cartilage status). Patients were contacted and asked to participate in this study by filling out the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. A correlation analysis was performed to evaluate the influence of length of surgical delay on the KOOS scores and on intra-articular injuries at the time of surgery.ResultsNinety-three patients were included in the study with a mean follow-up of 4 years. Twenty-nine patients were successfully contacted and completed the KOOS questionnaire. For the main objective, there was no significant outcome association between surgical delay and KOOS scores. For the secondary objective, there was a positive and statistically significant correlation between surgical delay and severity of medial meniscus injury and lateral femoral condyle cartilage injury, r=0.359 (p<0.001) and r=0.226 (p=0.029), respectively.ConclusionThe results of this study confirmed that there is an association between surgical delay and meniscus and cartilage injuries at the time of surgery. At a mean follow-up of 4 years, surgical delay was not yet associated with lower KOOS scores. These results emphasise the importance of rapid access to operative rooms for ACLR surgeries in an adolescent population.Level of evidenceLevel IV—Retrospective case series.