Surgical Versus Non-surgical Treatment for ACL Injury
May 16, 2023
Surgical Versus Non-surgical Treatment for ACL Injury
Authored By: Ali Shahabi, Steve Phillips, Ellen Scholl, Selina Bains and Mohit Bhandari on Behalf of OrthoEvidence
Highlights
As of our updated search performed in April 2023, OE M.I.N.D. contains data from nearly 3,944 RCTs related to knee conditions with over 1,747,858 patients.
- For patients with anterior cruciate ligament (ACL) injury, early reconstruction was associated with superior outcomes in Tegner activity score, stability, re-injury and revision surgery compared to rehabilitation alone either up to 2 years or longer than 2 years follow-up.
- There was no significant difference between surgical and non-surgical treatment in composite clinical outcomes, pain, and incidence of return to preinjury activity level during follow-up periods of either up to 2 years or 2 to 15 years post treatment.
- In terms of either reconstruction or rehabilitation for ACL injury, a total of 47 studies were found to be currently ongoing around the world, aiming to recruit over 12,000 patients based on data from clinicaltrials.gov.
- Since 2005, the manufacturers that have published the most research associated with reconstruction for ACL are Smith & Nephew, Arthrex, DePuy Synthes, Ethicon and Mitek.
Anterior cruciate ligament (ACL) injury is a common orthopaedic condition that affects knee joint stability and is associated with time lost from sports and an increased risk of osteoarthritis (Hewett et al., 2006; Lien-Iversen et al., 2020). Studies have reported an annual incidence of ACL injuries between 0.15% and 3.7% among professional athletes, while this incidence continues to increase (Moses et al., 2012; Secrist et al., 2016). Treatment of ACL injury includes both surgical reconstruction and non-surgical options of rehabilitation, bracing and activity modification (Bogunovic & Matava, 2013). Over 130,000 ACL reconstructions
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