Table 4.
Summary of Timing of Surgery RCTs
| RCT | Level of Evidence | Interventions | Outcome Measures | Results | |
|---|---|---|---|---|---|
| KANON trial | Frobell et al., 201041 | I | Structured rehabilitation plus early ACLR vs structured rehabilitation with optional delayed ACLR at 2 years’ FU (n = 121) | KOOS, SF-36, Tegner Scale. | No statistically significant differences between the 2 groups. |
| Frobell et al., 201342 | at 5 years’ FU | KOOS, SF-36, Tegner activity scale, meniscal surgery, and radiographic osteoarthritis | No statistically significant differences between the 2 groups. | ||
| Kiadaliri et al., 201643 | Economic evaluation at 5 years | Cost-effectiveness QALYs | No significant differences between the groups. | ||
| Flosadottir et al., 201848 | at 6 years’ FU | Knee Self-Efficacy Scale | No significant differences between the groups | ||
| Culvenor et al., 201944 | Secondary analysis at 5 years’ FU | PFJ cartilage loss MRI based | Early ACLR group had significantly greater loss of patellar cartilage thickness compared with optional delayed ACLR. | ||
| Same trial | Eriksson et al., 201845 |
II | ACLR within 8 days of injury vs delayed after normalized ROM 6-10 weeks after injury at 6 months’ FU (n = 70) | Visual analog scale, ROM, IKDC, Stability | No significant differences between the 2 groups, although less muscle atrophy in the early group compared with their contralateral side. |
| Von Essen et al., 202046 | At 1-year FU | IKDC, stability, number of sick-leave days | No significant differences between the groups in clinical outcomes, significantly more sick days taken in the delayed group. | ||
| Von Essen et al., 202047 | At 2 years’ FU | IKDC, KOOS, and manual stability measurements | No significant differences between the groups. | ||
| Bottoni et al.,200849 | I | Early (<21 days) vs delayed (> 6 weeks) hamstring autograft ACLR at 1-year FU (n = 69) | KT-1000, SANE, Lysholm, and Tegner Activity Score | No statistically significant differences between the groups. | |
| Chen et al., 201550 | II | Acute (3-7 weeks) vs chronic (6-11 months) ACLR using ligament advanced reinforcement system (LARS) artificial ligament in young adults (n = 55) | Lysholm scale, Tegner rating, a KT-1000, IKDC, Isokinetic strength quadriceps and hamstring | No significant differences between the groups. | |
| Manandhar et al., 201851 | II | Early (3 weeks) vs delayed (6 weeks) ACLR (n = 104) | ROM, IKDC and Tegner scores | No significant differences between the groups | |
ACLR, anterior cruciate ligament reconstruction; FU, follow-up; IKDC, International Knee Documentation Committee; KOOS, Knee Injury and Osteoarthritis Outcome Score; MRI, magnetic resonance imaging; PFJ, patellofemoral joint; QALYs, quality-adjusted life years; ROM, range of motion; SANE, Single Assessment Numerical Evaluation; SF-36, Short Form-36.