Importance of Restricting Sportive Activity and Time from Injury to Surgery in Anterior Cruciate Ligament Reconstruction

OBJECTIVES It is unclear that how long reconstruction may be delayed before additional intraarticular injuries occur. Our aim was to determine the relationship of time period from injury to surgery with the incidence of meniscal and chondral injuries recorded at the time of surgical treatment for ACL tears. The effect of sportive activity restriction, grade of chondral lesions and their locations were also evaluated. PATIENTS AND METHODS 213 patients who underwent arthroscopic anterior cruciate ligament reconstruction were evaluated retrospectively. Data were analyzed for association between time period before surgery and patients sportive activity restriction with rates of meniscal and chondral injuries. According to time from initial trauma to surgery less than 12 months grouped as group I (101 patients) and 12 months and longer defined as group II (81 patients). Patients who had surgery before 12 months were divided into groups of smaller time scales (0 to 3 months, 4 to 6 months, 7 to 9 months, 10 to 12 months) to examine the relationships more closely. For sportive activity restriction a functional scale was used that described restricted activities including military training. RESULTS One hundred eighty-two patients were included to the study. 81 patients restricted sportive activity before surgery. 18 (% 22.2) of these patients had chondral injury [6 (% 33.3) operated before 12 months and 12 (% 66.7) operated after 12 months]. The difference was statistically significant (p=0,005). 81 patients (group II) were operated after 12 months. There were 44 (% 54.3) patients with chondral injury in this group [32 (% 72.7) patients were who continued their sportive activity and 12 (% 27.3) patients who restricted their sportive activity]. The difference was statistically significant (p=0,026). Correlation analysis showed that with increasing time from initial trauma to surgery chondral lesion incidence and grade of these lesions increases (p<0,001, p=0,001). CONCLUSION The results indicate that the prolonged time from injury to surgery and continuing sportive activity before surgery increases the incidence of the chondral lesions. Also, time limit of 12 month is important to prevent chondral injury in anterior cruciate ligament reconstruction.