{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:10:20Z","timestamp":1791389420161,"version":"4.3.3"},"reference-count":58,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anterior cruciate ligament (ACL) injuries are common, and ACL reconstruction (ACLR) restores stability and enables return to sport. To date, however, studies have failed to show that ACLR prevents long-term osteoarthritis, but the role of timing of ACLR in osteoarthritis has not been extensively examined in meta-analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To compare the risk of long-term osteoarthritis after early versus delayed ACLR in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis; Level of evidence, 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The PubMed, Embase, and Cochrane Library databases were searched from 2000 to August 2024 for studies comparing osteoarthritis between early and delayed ACLR at a minimum 5-year follow-up. Outcomes are reported as risk reduction with 95% confidence interval for osteoarthritis incidence, and odds ratio with 95% confidence interval for difference in time from injury to surgery. Random-effects models were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seventeen studies (3953 ACLRs) were included (mean age, 28.8 years; 67% male; mean follow-up, 13.3 years; 52% meniscectomy; 31% osteoarthritis incidence). The quality of the studies was rated as moderate, with a Methodological Index for Non-Randomized Studies score of 78% of maximum. Overall, earlier ACLR led to a 10% reduction in osteoarthritis compared with delayed ACLR (95% CI, 6%-14%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Two studies (1474 patients) reported a 6% incidence reduction when ACLR was performed within versus after 1 month (95% CI, 2%-10%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .005). Similarly, 4 studies (349 patients) reported a 16% incidence reduction when ACLR was performed within versus after 6 months (95% CI, 5%-26%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004), and 5 studies (2248 patients) showed a 13% osteoarthritis reduction with ACLR within versus after 12 months (95% CI, 6%-20%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003). Six studies (685 patients) reported that patients without osteoarthritis were operated on a mean 15 months earlier than patients who developed osteoarthritis (95% CI, 2-29 months;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This systematic review with a 5-year minimum follow-up demonstrates that shorter time from injury to ACLR was associated with a decreased incidence of long-term osteoarthritis. This reduced risk was already seen when surgery was performed within 1 month but most pronounced within 6 months and 12 months.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251371330","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T07:00:20Z","timestamp":1767769220000},"page":"447-456","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Early Anterior Cruciate Ligament Reconstruction Is Associated With Decreased Risk of Osteoarthritis Compared With Delayed Reconstruction: A Systematic Review and Meta-analysis"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7940-5152","authenticated-orcid":false,"given":"Jelle P.","family":"van der List","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"},{"name":"Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cory","family":"Meixner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"},{"name":"Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher C.","family":"Kaeding","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"},{"name":"Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Magnussen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"},{"name":"Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Flanigan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"},{"name":"Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513508376"},{"key":"e_1_3_2_3_2","unstructured":"American Academy of Orthopaedic Surgeons. 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