Editorial Commentary: Variations of National Health Systems: Time From Injury to Surgery Can Affect Anterior Cruciate Ligament-Medial Collateral Ligament Treatment Outcomes.

Abstract

A recent investigation using the Swedish National Knee Registry large database showed that "The risk of ACL revision did not differ between HT and PT autografts in patients undergoing ACL reconstruction with a non-surgically treated MCL injury. However, the use of ST-G was associated with poorer two-year patient-reported knee function compared with the ST." However, the Swedish Health care system is so unique that the results may not be universally applicable. Sweden provides universal health care, which is laudable, but there was an average delay of 314 days between injury and surgical intervention. This suggests that the medial collateral ligament (MCL) injury had already become chronic and the anterior cruciate ligament surgery was not effective for or directed toward acute MCL pathology. The timing and MCL treatment algorithm is different from published recommendations. Delay may have negative consequences.