According to the Swedish ACL Register, surgery is performed an average of one year after an injury. Both knowledge and consensus about the optimum waiting time are in short supply.
Martina Åhlén, a doctoral student and orthopedic specialist, examined data for patients who received ACL reconstruction using hamstring tendon (HT) autografts, the most common method.
Higher level of activity
One of her studies found that patients who were operated on within five months regained a higher level of activity than those who waited an average of more than two years.
“Not everyone who suffers an ACL injury needs surgery,” Dr. Åhlén says. “Physical therapy is often the first-line treatment. However many elite athletes choose surgery right off the bat. And reconstruction is recommended if the knee remains unstable following physical therapy.”
Loss of strength
Another study involving 19 patients who underwent ACL reconstruction showed that the use of HT autografts often left a significant loss of strength in deep knee flexion, which may affect gymnasts, wrestlers and certain other athletes.
Whether or not a patient receives ACL reconstruction, such injuries are associated with elevated risk of arthrosis, which can lead to stiff and tender joints. One hypothesis is that the risk of arthrosis has inflammatory causes.
Eight years post-surgery
In another study, Dr. Åhlén monitored eleven patients eight years post-surgery. She did not find a significantly higher level of inflammatory proteins or cartilage markers in the knee that had been operated on than the other knee.
Dr. Åhlén defended Anterior Cruciate Ligament Reconstruction Using Semitendinosus and Gracilis Autografts on May 29.
Link to the thesis: https://gupea.ub.gu.se/handle/2077/38463
The image shows the semitendinosus and gracilis tendons, which are used in ACL reconstruction. Photo: Juri Kartus
For additional information, feel free to contact:
Martina Åhlén, Sahlgrenska Academy, University of Gothenburg
Cell: +46 706 795 870
Principal supervisor: Mattias Lidén, Cell: +46 707 292 129; firstname.lastname@example.org