In the 1980's, it was common for patients to have their ACL reconstruction within one week of the injury. These was because surgeons believed that this would prevent meniscal and articular cartilage damage. These patients also had lots of problems regaining full range of motion (ROM) partly due to arthrofibrosis (or scarring from bleeding, inflammation). These patients had a loss of knee extension (straightening) which was functionally worse than prior to their surgery. Even now, there are patients who tell us that they were advised to have the reconstruction as soon as possible. So what does the published studies say?
Results on studies for early versus later reconstruction are mixed, some report good results while others are poor. A major problem was the the studies were often retrospective (looking backwards) in nature, so there was so some bias and confounding factors.
To sum up, the time interval from your ACL injury to reconstruction is not as important as the condition of your knee at the time of injury. Prior to your operation, your knee should have full ROM with minimum or no swelling as compared to your uninjured side. Pain should be minimal and you must be mentally prepared for the ACL reconstruction, and more importantly the lengthy rehabilitation required after the operation. A good surgical technique is only as good as its rehabilitation.
No comments:
Post a Comment