Brief summary, from the abstract
At 5 years after an ACL injury, patients who had reconstruction surgery and those treated with rehabilitation alone had largely similar functional and radiographic outcomes, provided both groups completed a progressive criterion-based rehabilitation program.
- In this cohort of 105 athletes (mean age 34.3 years) followed 5 years, surgical and nonoperative groups did not differ in quadriceps strength (P = .817), single-legged hop performance (P = .234-.955), activity level (P = .349-.400), patient-reported pain, symptoms and quality of life (P = .090-.941), or presence of knee osteoarthritis (P = .102-.978).
- Surgically treated patients reported higher global ratings of knee function (P = .001) and lower fear (P = .035), but were more likely to have knee joint effusion (P = .016).
- Both operative and nonoperative paths can lead to favorable outcomes when paired with progressive rehabilitation; the authors note more work is needed to identify who is the best candidate for each approach.
- Evidence is from a single Level 2 cohort study, not a randomized trial, so it shows association rather than proof of cause.
Clinically assessing this area? See the knee special tests.