The Optimal Timing for Anterior Cruciate Ligament Reconstruction With Respect to the Risk of Postoperative Stiffness

Kwok, Chun Shing; Harrison, T; Servant, Chris

doi:10.1016/j.arthro.2012.09.005

Cited by 72 publications

(73 citation statements)

References 30 publications

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“…Among these factors, timing of surgical treatment after ACL injury is still controversial (Krutsch et al 2015; Kwok et al 2013). In this study, we divided patients into two groups according to the preoperative periods of 60 days.…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review classified the injury-to-surgery interval as either early (ranging from within 2 days to 7 months) or delayed (ranging from 3 weeks to 24 years) and found that 8 articles recommended early reconstruction, whereas the majority of the literature found no difference in outcome between early and delayed surgery (Andernord et al 2013). These indicate that the effect of the timing of surgery after injury is still controversy (Krutsch et al 2015; Kwok et al 2013). …”

Section: Introductionmentioning

confidence: 99%

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Inflammatory cytokine levels in synovial fluid 3, 4 days postoperatively and its correlation with early-phase functional recovery after anterior cruciate ligament reconstruction: a cohort study

et al. 2016

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BackgroundSynovial fluid was collected prior to and at 3 to 4 days after ACL reconstruction to investigate the correlation between inflammatory cytokine levels in the acute phase after surgery and physical functional recovery at 3 months postoperatively.Methods For this purpose, 79 patients with ACL reconstruction using semitendinosus tendons were included in the study. Median days from injury to surgery were 80 days (13–291 days). Synovial fluid was obtained just before surgery and at 3 to 4 days after surgery. Physical activity of each patient was evaluated at 3 months postoperatively, and scored from 0 (hard to walk) to 5 (run). Patients able to jog (score 4) or run (score 5) were considered as the “quick recovery” group and others (scores 1–3) as the “delayed recovery” group.ResultsPhysical activity recovery scores in the early surgery group (preoperative period less than 60 days; Group I) were significantly better than those in the delayed surgery group (Group II). Among the cytokines tested, TNF-alpha and IL10 levels in synovial fluid were significantly higher in Group II at 3 to 4 days postoperatively, while levels of these cytokines were quite comparable preoperatively between the groups. Increased IL1-beta expression was noted in the delayed recovery group at 3 to 4 days postoperatively. In addition, levels of IL6, IL10 and IFN-gamma also tended to increase in patients with delayed recovery.ConclusionDelayed ACL reconstruction increases levels of inflammatory cytokines in synovial fluid after surgery and correlates with a prolonged recovery of short-period physical activity of the patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inflammatory cytokine levels in synovial fluid 3, 4 days postoperatively and its correlation with early-phase functional recovery after anterior cruciate ligament reconstruction: a cohort study

et al. 2016

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“…In patients with an isolated, complete rupture of the ACL, reconstruction and early rehabilitation is the gold standard. There is still no consensus regarding the timing of the surgery and best graft choice [15][16][17][18][19]. In the case of MCL damage, conservative treatment is considered the modality of choice due to the fact that the ligament has high healing potential [2,3,20].…”

Section: Discussionmentioning

confidence: 99%

“…W przy pad ku izo lo wa ne go, cał ko wi te go uszko dzenia wię za dła krzy żo we go przed nie go zło tym stan dardem le cze nia jest ope ra cja re kon struk cyj na oraz wcze sna re ha bi li ta cja. Dys ku syj ny po zo sta je okres, któ ry jest naj lep szy, aby prze pro wa dzić za bieg ope racyj ny oraz do bór prze szcze pu [15][16][17][18][19]. Z ko lei w przypad kach uszko dzeń wię za dła po bocz ne go pisz czelowe go, z uwa gi na świet ny po ten cjał do go je nia, le czeniem z wy bo ru jest le cze nie za cho waw cze [2,3,20].…”

Section: Dys Ku Sjaunclassified

Results of Two-Stage Operative Treatment of Anteromedial Instability of the Knee

Piątkowski¹,

Płomiński²,

Sowiński³

et al. 2014

Ortop Traumatol Rehabil

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1.Two-stage operative treatment produces good or very good results in most patients. Nevertheless, there is a risk of complications in some cases, mostly in patients aged 40 years. Accordingly, two-stage treatment is currently recommended in younger individuals. 2. A complete MCL tear at the distal attachment should be given particular attention. Although such injury is rare, due to the anatomical determinants and the risk of Stener-like lesions, i.e. unhealed ML, surgery is recommended. Surgery produces good clinical and functional results.

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“…In einer jüngeren Metaanalyse aus dem Jahr 2013 unter Einschleusung von mehr als 900 Patienten zeigte sich, dass unabhängig von der Verwendung von Hamstring-Transplantaten oder BonePatella-Tendon-Bone-Transplantaten kein erhöhtes Arthrofibroserisiko gesehen wurde, wenn innerhalb der ersten, zweiten oder auch dritten Woche nach Trauma operiert wurde [7]. Die aktuelle Studienlage lässt daher die Schlussfolgerung zu, dass der korrekte Operationszeitpunkt letztendlich individuell, insbesondere auch abhängig von den Begleitverletzungen zu sehen ist.…”

Section: Operationszeitpunktunclassified

Rekonstruktion des vorderen Kreuzbandes

Schoepp

2015

Trauma Berufskrankh

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In den letzten Jahren nimmt die Anzahl der operativ behandelten vorderen Kreuzband (VKB)-Verletzungen drastisch zu. Für die USA wird hierbei ein Anstieg um 55 % zwischen den Jahren 1994 und 2006 verzeichnet. Ursächlich für den Anstieg der operierten Fälle ist einerseits das veränderte Freizeitverhalten, andererseits aber auch die Zunahme der technischen Möglichkeiten in der Kreuzbandchirurgie [2]. Die Behandlungskosten je Kreuzbandersatzplastik sind immens und liegen bei über 80.000 €. Dem operativen Eingriff schließt sich eine lange Rehabilitationsphase von bis zu 12 Monaten an. Shelbourne [14] beschreibt trotz der heutigen operativen Möglich-keiten eine Rerupturrate von 17 %. Trotz aller Bemühungen liegt die Arthroseprä-valenz nach mehr als 10 Jahren (KellgrenLawrence ≥ 2) bei isolierter VKBVerletzung bei 13 %, während die Prä-valenz bei zusätzlichem Meniskusschaden mit 48 % angegeben wird [10].

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The Optimal Timing for Anterior Cruciate Ligament Reconstruction With Respect to the Risk of Postoperative Stiffness

Cited by 72 publications

References 30 publications

Inflammatory cytokine levels in synovial fluid 3, 4 days postoperatively and its correlation with early-phase functional recovery after anterior cruciate ligament reconstruction: a cohort study

Inflammatory cytokine levels in synovial fluid 3, 4 days postoperatively and its correlation with early-phase functional recovery after anterior cruciate ligament reconstruction: a cohort study

Results of Two-Stage Operative Treatment of Anteromedial Instability of the Knee

Rekonstruktion des vorderen Kreuzbandes

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