Early surgical reconstruction versus rehabilitation with elective delayed reconstruction for patients with anterior cruciate ligament rupture: COMPARE randomised controlled trial

Este estudio ha sido identificado como potencialmente de alto impacto. La métrica de alto impacto de OE, basada en la inteligencia artificial, estima la influencia que puede tener un artículo integrando señales procedentes tanto de la revista en la que se publica como del contenido científico del propio artículo. Desarrollado mediante el procesamiento del lenguaje natural más avanzado, el modelo de Alto Impacto de OE predice con mayor precisión el futuro rendimiento de las citas de un estudio que el factor de impacto de la revista por sí solo. Esto permite reconocer antes las investigaciones clínicamente significativas y ayuda a los lectores a centrarse en los artículos con más probabilidades de configurar la práctica futura.

Resumen del estudio

One hundred sixty-seven patients with acute ACL rupture were randomized to receive either early ACL reconstruction (n=85) or rehabilitation with the option for delayed ACL reconstruction after three months (n=82). The primary outcome was patients’ perceptions of symptoms, knee function, and ability to participate in sports, assessed using the International Knee Documentation Committee (IKDC) score over a 24-month period. Secondary outcomes included the Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, return to pre-injury sporting level, knee instability (giving way), and patient satisfaction. After two years, the early ACL reconstruction group showed a significantly better IKDC score, but the clinical relevance of this difference is uncertain. At three months, the rehabilitation group had a significantly better IKDC score, but by nine months, the advantage shifted toward the early ACL reconstruction group. Half (50%) of the rehabilitation group eventually required delayed reconstruction. Overall, early ACL reconstruction led to small but statistically significant improvements in knee function at two years, though non-operative treatment was successful for half of the patients.