Time from Injury to Surgery in ACL Reconstruction and Its Impact on Meniscal and Chondral Damage at Arthroscopy: A Retrospective Study from a Tertiary Care Hospital in Pakistan

Abstract

Objective: To determine whether the interval between ACL injury and reconstruction is associated with increased prevalence and severity of meniscal tears and chondral lesions identified during arthroscopy. Methodology: This Comparative Cross-Sectional Study was conducted in the Department of Orthopedics and Spine Surgery, Hayatabad Medical Complex (HMC), Peshawar, from January to March 2026. We reviewed medical records and arthroscopic operative reports of patients who underwent ACL reconstruction at HMC Peshawar during a defined historical period. We divided patients into two groups based on the interval from ACL injury to surgical reconstruction: An Early Surgery Group (≤3 months) and a Delayed Surgery Group (>3 months). We analyzed the data using SPSS version 23. Results: This study examined 84 individuals undergoing ACL reconstruction. We categorized participants into an early reconstruction group (≤6 months, n=42) and a delayed reconstruction group (>6 months, n=42). Medial meniscal tears were observed in 10 (23.8%) patients in the early group compared with 20 (47.6%) in the delayed group. Any meniscal injury was present in 16 (38.1%) early patients and 27 (64.3%) delayed patients. Chondral damage was identified in 7 (16.7%) and 18 (42.9%) patients, respectively. High-grade chondral lesions were also more frequent in the delayed group, occurring in 2 (4.8%) early versus 8 (19.0%) delayed patients. Conclusion: The present study concluded that ACL reconstruction done more than 6 months after injury was associated with higher rates of chondral damage, overall meniscal injury, high-grade chondral lesions, and medial meniscal tears.