Delayed ACL Reconstruction Linked to New Meniscal Tears

MONDAY, Nov. 6, 2023 (HealthDay News) — For pediatric patients, delayed anterior cruciate ligament (ACL) reconstruction is associated with an increased risk for new meniscal tears; however, for adults, operative delay does not pose an increased risk, according to a study published online Oct. 6 in the Orthopaedic Journal of Sports Medicine.

Arjun Gupta, from Johns Hopkins University in Baltimore, and colleagues examined whether and how delay of ACL reconstruction is associated with the risk for new meniscal tears in adult and pediatric patients. The adjusted relative risk (ARR) for new meniscal tears was examined after delayed operative treatment (eight or more weeks from injury) in 173 pediatric and 369 adult patients.

The researchers found that fewer than half of the meniscal tears observed arthroscopically had been absent on initial magnetic resonance imaging, performed within three weeks after injury (mean time, 1.0 ± 0.8 weeks for pediatric patients; 1.1 ± 0.7 weeks for adults). In 15 and 16 percent of pediatric and adult patients, respectively, new medial meniscal tears occurred, while new lateral meniscal tears occurred in 48 and 34 percent, respectively. Delayed ACL reconstruction was associated with a higher risk for new medial tears (ARR, 3.9; 95 percent confidence interval, 1.5 to 10) but not new lateral tears (ARR, 0.8; 95 percent confidence interval, 0.4 to 1.5) among pediatric patients. In contrast, no significant increase in the risk for meniscal tears was seen in association with operative delay in adults.

“What we have shown with children is that the longer you wait, the more damage may be done to the knee,” senior author R. Jay Lee, M.D., from the Johns Hopkins Children”s Center, said in a statement.

One author disclosed ties to industry.

Abstract/Full Text