Table 1 Summary of the included studies
Study name | Design | Total no. of patients (criteria for early vs delayed) | Combined ligament injury | Combined meniscus injury (positive/negative) | Combined cartilage injury (positive/negative) | Clinical evaluation | Overall Follow-up |
|---|---|---|---|---|---|---|---|
Isolated ACL injury | |||||||
Retrospective review Cross-sectional study | 293 Early: 160 cases Delayed: 133 cases (0–6 months vs longer than 7 months) | Isolated ACL injury | Early: Total: 86 cases/ MM tear: 42 cases/ LM tear: 44 cases Delayed: Total: 109 cases/MM tear: 88 cases/ LM tear: 21 cases | Early: Total: 83 cases Delayed: Total: 112 cases | Not reported | Not reported | |
Tandogan et al., 2004 [48] | Retrospective study | 764 Early: 510 cases Delayed: 254 cases (0–12 months vs more than 12 months) | Isolated ACL injury | Total meniscus tear: 556 cases | Early: 31 cases Delayed: 55 cases | Not reported | Not reported |
Manandhar et al., 2018 [40] | Prospective study | 104 Early: 53 cases Delayed: 51 cases (within 3 weeks vs after 6 weeks) | Isolated ACL injury | Early: Total: 22 cases / LM tear: 12 cases / MM tear: 6 cases/ Both menisci torn: 4 cases Delayed: Total: 34 cases /LM tear: 8 cases/ MM tear: 20 cases/ Both menisci torn: 6 cases | Early: 10 cases Delayed: 28 cases | IKDC Early: 69.68 ± 8.14 vs delayed: 67.14 ± 6.08 Tegner Early 4.15 ± 1.45 vs delayed: 23.72 ± 1.34 | Not reported at least 24 weeks |
Meighan et al., 2003 [42] | Retrospective study | 31 Early: 13 cases Delayed: 18 cases (within 2 weeks vs between 8 and 12 weeks) | Isolated ACL injury | Early: Total: 3 cases Delayed: Total: 4 cases | Not reported | Not reported | 1 year |
Nikolic et al., 1998 [41] | Retrospective study | 182 Early: 66 cases Delayed: 65 Excluded: 51 cases (not reported, acute ACL vs ACL-deficient knee) | Isolated ACL injury | Early: Total: 51 cases Delayed: Total: 53 cases | Not reported | Not reported | Not reported |
Raviraj et al., 2010 [25] | Retrospective study | 99 Early: 51 cases Delayed: 48 cases (< 2 weeks vs 4–6 weeks) | Isolated ACL injury | Early: Total: 38 cases/MM tear: 18 cases/ LM tear: 20 cases Delayed: Total: 35 cases/ MM tear: 13 cases/ LM tear: 22 cases | Early: 29 cases Delayed: 31 cases | Lysholm score: early 83.1 (80–90) vs delayed 84.2 (82–90) Tegner activity score: early 6.1 (5 to 8) vs delayed 5.9 (5 to 8) | 32 months (26–36) |
Hur et al., 2017 [38] | Prospective study | 91 Early: 48 cases Delayed: 43 cases (within 3 weeks vs more than 3 months) | Isolated ACL injury | Early: Total: 25 cases/ MM tear: 14 cases/ LM tear: 15 cases Delayed: Total: 27 cases/MM tear: 24 cases/ LM tear: 9 cases | Early: 15 cases, Delayed: 20 cases | Lysholm: Early: 94.5 ± 8.9 Delayed: 96.3 ± 3.7 Tegner: Early: 6.0 ± 1.6 Delayed: 5.6 ± 1.5 | Minimum 2 years |
Li et al., 2012 [39] | Retrospective study | 38 Early: 17 cases Delayed: 21 cases (< 3 weeks vs ≥ 3 weeks) | Isolated ACL injury | Early: Total: 2 cases Delayed: Total: 9 cases | Early: 0 cases, Delayed: 7 cases | Lysholm: Early: 94.7 ± 9.3 Delayed: 92.2 ± 7.8 Tegner: Early: 6.6 ± 1.9 Delayed: .6.3 ± 1.3 | Minimum 2 years |
Ahlen and Liden, 2011 [43] | Prospective cohort study | 61 Early: 30 cases Delayed: 31 cases (within 5 months vs More than 24 months) | Isolated ACL injury | Early: Total: 15 cases/ MM tear: 4 cases/ LM tear: 9 cases Delayed: Total: 20 cases/ MM tear: 14 cases/ LM tear: 2 cases | Early: 6 cases Delayed: 9 cases | Not reported | 25 months (18–43) |
Bottoni et al., 2008 [47] | Prospective, randomized cohort study | 70 Early: 35 cases Delayed: 35 cases (within 21 days vs beyond 6 weeks) | Isolated ACL injury | Early: Total: 32 cases/MM tear: 14 cases/ LM tear: 18 cases Delayed: Total: 24 cases/MM tear: 15 cases/LM tear: 9 cases | Early: 9 cases Delayed: 5 cases | SANE: 83.1 vs 81.4 Lysholm: 80.6 vs 83.4 Tegner 5.8 vs 4.9 | 366 days (185–869) |
Prospective, randomized cohort study | 55 Early: 27 cases Delayed: 28 cases (3–7 weeks vs 6–11 months) | Isolated ACL injury | Not reported | Not reported | Lysholm: 47.26 / 93.37 / 95.04 vs 54.1 / 91.64 / 92.64 Tegner: 2.7 / 6.3 / 6.3 vs 2.5 / 6.1 / 6.3 IKDC: 20/6/1/0 vs 17/9/2/0 | 61 months | |
Cipolla et al., 1995 [16] | Retrospective review | 770 Early: 218 cases Delayed: 552 cases (within 1 week vs later in different stages) | Isolated ACL injury | Early: Total: 63 cases Delayed: Total: 412 cases | Not reported | Not reported | Not reported |
Frobell et al., 2010 [45] | Prospective cohort study | 121 Early: 62 cases Delayed: 59 cases (less than 10 weeks vs more than 10 weeks) | Isolated ACL injury | Early: Total 40 cases Chronic: Total 50 cases | Not reported | KOOS subscale - pain: 87.2 vs 87.7 - symptoms: 78.7 vs 83.0 - daily function: 93.5 vs 94.7 - sports function: 71.8 vs 71.2 - QOL: 67.3 vs 63.0 SF-36 - physical: 82.1 vs 78.0 - mental: 88.3 vs 83.8 Tegner: 6.5 vs 5 | 24.6 months (24.4–24.7) vs 25.0 months (24.7–25.2) |
Frobell et al., 2013 [44] | Prospective cohort study (follow-up study of Frobell et al., 2010 [45]) | 121 Early: 61 cases Delayed: 59 cases (less than 10 weeks vs more than 10 weeks) | Isolated ACL injury | Early: Total 29 cases Delayed: Total 32 cases | Not reported | KOOS: 80 vs 82 KOOS subscale - pain: 91 vs 91 - symptoms: 83 vs 87 - daily function: 95 vs 97 - sports function: 76 vs 79 - QOL: 71 vs 69 SF-36 - physical: 85 vs 84 - mental: 87 vs 85 Tegner: 4 vs 4 | 5 years |
Herbst et al., 2017 [23] | Prospective cohort study | 160 Early: 51 cases Delayed: 55 cases (within 48 h vs after 6 weeks) | Isolated ACL injury | Early: MM tear: 8 cases/ LM tear: 14 cases/ Both menisci torn: 8 cases Delayed: MM tear: 13 cases/ LM tear: 13 cases/ Both menisci torn: 4 cases | Not reported | Tegner (isolated ACL): 6.7 ± 1.3 vs 6.3 ± 1.4 Tegner (with meniscus injury) 6.6 ± 1.3 vs 6.3 ± 1.5 | 24 months |
Fok et al., 2013 [37] | Retrospective comparative study | 150 Early: 97 cases Delayed: 53 cases (less than 12 months vs more than 12 months) | Isolated ACL injury | Early: Total: 58 cases Delayed: Total: 41 cases | Early: 40 cases Delayed: 25 cases | IKDC: with meniscal injury 60.4 vs without 61.3 IKDC: with chondral lesion 60.1 vs without 61.3 IKDC: Red-red tear 56.7 vs red-white tear 62.1 vs white-white tear 60.1 Tegner score: preop (< 12 months) 3.92 vs preop (> 12 months 3.41) | Not reported |
Multiligament injuries | |||||||
Krych et al., 2015 [58] | Retrospective study | 122 Early: 62 cases Delayed: 60 cases (within 3 months vs after 3 months) | KD I: 25 KD II: KD III: 72 KD IV: 16 | Early: 19 cases Delayed: 21 cases | Total cartilage injury 52 (48.0%) / 70 (52.0%) | Not reported | Not reported |
Tardy et al., 2017 [56] | Retrospective study | 39 Early: 22 cases Delayed: 17 cases (7–30 days vs after 3 months) | PMC vs PLC injury | Early: 6 cases Delayed: 7 cases | Not reported | Objective IKDC: PMC 2A, 16B,1C vs PLC 1A,13B,6C” Subjective IKDC: PMC 81 ± 15 vs PLC 70 ± 17″ Lysholm PMC 89 ± 7 vs PLC 79 ± 11 Sports activity level PMC: 8 at same level /10 decreased in activity level/1 stopped sports PLC: 4 at same level/10 decreased in activity level/ 6 stopped sports | 57 months (12–129) |
Moatshe et al., 2017 [59] | Prospective cohort study | 65 Early: 33 cases Delayed: 32 cases (less than 21 days vs more than 21 days) | KD I: 0 KD II: 4 KD III: 55 KD IV: 6 | 25 (38.5%) / 40 (61.5%) | 25 (38.5%) / 40 (61.5%) | Lysholm score Early: 86.9 ± 15 Delayed: 81 ± 19 Tegner activity Early: 4 ± 1.8/ Delayed: 4 ± 2 KOOS symptoms 78 KOOS pain 81 KOOS ADL 87 KOOS sport 54 KOOS QOL 64 Single leg hop test 88–93% of the uninjured leg | 13.1 years (10–18.8 ) |
Li et al., 2013 [51] | Retrospective study | 15 Early: 6 cases Delayed: 9 cases (< 3 weeks vs ≥3 weeks) | KD I: 0 KD II: 7 KD III: 8 KD IV: 0 | Not reported | Not reported | Lysholm score Early: 89.4 ± 4.4 Delayed: 82.1 ± 6.3 Tegner activity Early: 3.9 / Delayed: 3.4 | 7.5 years (6–12) |
Liow et al., 2003 [8] | Retrospective study | 22 Early: 8 cases Delayed: 14 cases (< 2 weeks vs ≥2 weeks) | KD I: 7 KD II: 2 KD III: 11 KD IV: 0 | Not reported | Not reported | Lysholm score Early: 87 (81–91) Delayed: 75 (53–100) Tegner activity Early: 5 / Delayed: 4.4 | 32 months (11–77) |
Noyes et al., 1997 [57] | Retrospective study | 11 Early: 7 cases Delayed: 4 cases (Early: mean 14 days Delayed: mean 22 months) | Both cruciate ligaments torn: 10, All ligaments torn: 1 case | Not reported | Early: 0 Delayed: 3 | Not reported | 4.5 years |
Subbiah et al., 2011 [50] | Retrospective study | 19 Early: 11 cases Delayed: 8 cases (< 3 weeks vs ≥3 weeks) | KD I: 5 KD II: 3 KD III: 11 KD IV: 0 | Total meniscus injury 16 (84%)/3 (16%) | Not reported | Lysholm score Early: 93.3 ± 6.6 Delayed: 90 ± 5.8 | 22 months (14–33) |
Wascher et al., 1999 [49] | Retrospective study | 13 Early: 9 cases Delayed: 4 cases (< 3 weeks vs ≥3 weeks) | ACL/PCL/MCL: 7 (53.8%) ACL/PCL/PLC: 6 (46.2%) | Early: Total: 4 cases Delayed: Total: 2 cases | Not reported | Lysholm score Early: 91.8 ± 7.1 Delayed: 79.3 ± 22.7 IKDC: 6 nearly normal (46.2%) Meyers: 11 excellent or good (84.6%) | 38 months |
Zhang et al., 2013 [52] | Retrospective study | 59 Early: 48 cases Delayed: 11 cases (< 3 weeks vs > 3 weeks) | ACL/PCL/MCL/PLC | Not reported | Not reported | Lysholm score Early: 87.6 ± 10.2 Delayed: 80.5 ± 13.3 | 2.5 years |
Tzurbakis et al., 2006 [10] | Retrospective study | 48 Early: 38 cases Delayed: 10 cases (within 3 weeks vs more than 3 weeks) | Group A (ACL + medial): 12 (25%) Group B (cruciate + PLC): 11 (22.9%) Group C (bicruciate + collateral): 25 (52.1%) | Total meniscus tear MM: 20 (41.7%) / 28 (58.3%) LM: 13 (27.1%) / 35 (72.9%) | Total cartilage injury 6 (12.5%) / 42 (87.5%) | Tegner: Early: 4.4 ± 2.1 Delayed: 5.2 ± 2.2 Lysholm: Early: 87 ± 12.3 Delayed: 81.7 ± 13.3 | 51.3 ± 29.9 months (24–96) |
Harner et al., 2004 [9] | Retrospective cohort study | 31 Early: 19 cases Delayed: 12 cases (within 3 weeks vs more than 3 weeks) | ACL/PCL/MCL/PLC | Not reported | Not reported | Lysholm: Early: 91 Delayed: 80 KOOS (daily): Early: 91 vs Delayed: 84 KOOS (sports): Early: 89 vs Delayed: 69 Meyers: Early: 16/19 vs Delayed: 7/12 | 44 M / minimum 2Y |
Owens et al., 2007 [54] | Retrospective study | 28 Early: 20 cases Delayed: 8 cases (within 14 days vs greater than 14 days) | ACL/PCL/MCL/PLC | Total meniscus injury 14 (50%) / 14 (50%) | Not reported | Lysholm score Early: 91.2 ± 6.52 Delayed: 83.6 ± 7.3 | 48 months (13–82) |
Fanelli et al., 1996 [55] | Retrospective study | 21 Early: 13 cases Delayed: 8 cases (2–4 weeks vs 6 months–16 years) | All were PCL/PLC injuries | Not reported | Not reported | Lysholm score Early: 91.2 / Delayed: 91.6 Tegner: Early 5.2 / Delayed: 5.0 | Minimum 24 months (24–54) |
Wajsfisz et al., 2014 [53] | Retrospective study | 53 Early: 10 cases Delayed: 43 cases (within 21 days vs more than 21 days) | Not reported | Not reported | Not reported | Lysholm score Early: 83 / Delayed: 76.5 | 49 months (12–146) |