ACL Injuries: Surgical versus Non-surgical Treatment
There are approximately 200,000 ACL (Anterior Cruciate Ligament) injuries in the US every year. ACL injuries usually occur in active individuals, especially those participating in sports. The most common sports associated with ACL injury are basketball, soccer, skiing and football. About half of these injures are treated with surgical reconstruction procedures.
So who should have surgery and who should opt for conservative care? A recent research study has led to a better understanding of long-term outcomes with operative versus non-operative care[1]. Interestingly, the overall conclusion of the authors of this cohort study was that there were no significant differences in knee function or muscle strength after 2 years between those that opted for surgery compared to those who were treated conservatively. However, in order to interpret this finding it is important to note that more of the surgically treated individuals chose to return to level I sports. Level I sports are generally those that have higher risk for injury. In fact, the desire to return to sport is weighed heavily in the operative versus nonoperative treatment decision.
There are of course many factors that need to be considered in determining optimal treatment after ACL injury. If you have an injury, it is best to consult with an Orthopedic surgeon.
Regardless of the route chosen for those with ACL injury, rehabilitation is a critical aspect of recovery. Since delaying surgery does not impact the outcome of operative management, it is best to start treatment right away. Physical therapists provide comprehensive, conservative management as well as post-surgical care for ACL injury.
Marcia Spoto PT, DC, OCS
1. Grindem H et al. Nonsurgical or surgical treatment for ACL injuries: knee functionsports participation, and knee reinjury. J Bone Joint Surg. 2014; 96: 1233-1241.