Early versus delayed surgery for anterior cruciate ligament reconstruction: a systematic review and meta-analysis

Knee Surg Sports Traumatol Arthrosc. 2010 Mar;18(3):304-11. doi: 10.1007/s00167-009-0965-z. Epub 2009 Oct 17.


There is no consensus in the literature regarding the optimal timing of surgical reconstruction of the ruptured anterior cruciate ligament (ACL). Previous authors have suggested that early reconstruction may facilitate an early return to work or sport but may increase the incidence of post-operative complications such as arthrofibrosis. This study systematically reviewed the literature to determine whether ACL reconstruction should be performed acutely following rupture. Medline, CINAHL, AMED, EMBASE databases and grey literature were reviewed with a meta-analysis of pooled mean differences where appropriate. Six papers including 370 ACL reconstructions were included. Early ACL reconstructions were considered as those undertaken within a mean of 3 weeks post-injury; delayed ACL reconstructions were those undertaken a minimum of 6 weeks post-injury. We found there was no difference in clinical outcome between patients who underwent early compared to delayed ACL reconstruction. However, this conclusion is based on the current literature which has substantial methodological limitations.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries*
  • Humans
  • Knee Injuries / surgery*
  • Orthopedic Procedures
  • Recovery of Function*
  • Risk
  • Time Factors