What are the risks of delaying ACL reconstruction?
Delaying ACL reconstruction risks ongoing intra-articular damage due to knee instability. I conducted a study with my colleague, Todd Lawrence, MD, PhD, to quantify these risks and to identify independent risk factors for patients 14 years and younger.1 Using logistic regression models we found that time to reconstruction was significantly associated with medial meniscus tears and chondral injuries in the group with delay greater than 12 weeks. For medial meniscus tears, time to reconstruction and a history of instability were identified as independent risk factors. The odds ratio for delaying treatment was 4 and 11 for instability. Treatment delay was also associated with an increase in tear severity including irreparable tears. When is nonoperative management indicated? Nonoperative management is indicated when a patients physical, mental, or social situation precludes them from surgical treatment or from participating in rehabilitation. Nonoperative treatment is also indicated if fa
