Early vs. Delayed ACL reconstruction “early” anterior cruciate ligament reconstruction

The decision to perform ACL reconstruction early after the injury is affected by multiple factors. Risks of performing reconstruction early are related to the development of arthrofibrosis and potentially operating on some patients that may recover normal knee laxity without surgery. On the other hand, not performing ACL reconstruction within a short time has the potential for further meniscus and cartilage injuries. Timing of surgery could also be affected by cost-effectiveness considerations and by demands to return as early as possible to sports in professional athletes. This chapter summarizes current knowledge about the association between timing of surgery and risk of arthrofibrosis, reinjury to the menisci and articular cartilage, as well as economic considerations and provides evidence-based tools for implementing wise decisions in this respect.