Abstract
Introduction
Aim of our study was to find an association of additional intra-artricular derangements due to the delay in referring a patient with Anterior Cruciate Ligament (ACL) injury to a consultant orthopaedic clinic.
Methods and results
We carried out a retrospective review of 50 patients who underwent ACL reconstruction (performed arthroscopically taking semitendinosis tendon graft) between July 2007 and November 2008. Orthopaedic referrals were grouped into A&E-group (48%) and GP-group (52%). Average time span between initial injury and patient's first contact with an orthopaedic surgeon was 10 days in the AE-group and 30 months in the GP-group.
On analysing the MRI scans we found a significant difference regarding the presence of additional injuries: A&E-group had less medial meniscus injuries (43.75%) compared to the GP-group (65%). Lateral meniscus injuries were present in 18.75% in A&E-group and in 35% in GP-group. Findings during arthroscopic ACL reconstruction revealed following differences: A&E-group had less medial meniscus injuries (30.43%) compared to the GP-group (46.15%). Lateral meniscus injuries were 43.48 % and 30.77 % in A&E-group and GP-group respectively.
Lysholm Knee Scoring system was used in both the groups pre- and postoperatively. The A&E-group had better results preoperatively (average 56.7) and postoperatively (average 95.5) when compared to the GP group which had shown scores to be 50.4 (pre-op) and 90.7 (post-op).
Conclusion
Delay in final diagnosis and treatment was much longer in the GP-group. There were higher incidences of meniscus injuries in the GP-group based on both MRI and arthroscopic findings. The outcome scores were better in the A&E-group. Our results do support the fact that it is essential to have an early referral, diagnosis and treatment of ACL injuries.
