title: Is Anterior Cruciate Reconstruction Superior to Conservative Treatment?
abstract: Not all patients who have a rupture of the anterior cruciate ligament (ACL) elect to have surgical reconstruction. The aim of this study was to assess the short-to-medium-term results of patients who chose conservative management in comparison to patients who had reconstructive surgery within the same time period. Sixty-three patients with an ACL injury were retrospectively studied. Forty patients were managed, according to patient choice, with ACL reconstruction and 23 conservatively. Four validated questionnaires were used to assess general and knee-specific function in a cohort with a median age of 32 years and a median follow-up period of 38 months. Patients were matched on demographic variables except for gender. There were no statistically significant differences in the outcome measures, and the majority of patients would proceed with the same treatment in the event the control leg became injured. Patients who elect to have conservative management of an ACL rupture can achieve similar function and satisfaction to those who elect to have reconstruction. Until a large randomized controlled trial is conducted, patients need to be made aware of the merits of both management strategies and the lack of evidence of superiority of one over the other.
authors.affiliation: Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, United Kingdom.
authors.forename: A G
authors.initials: AG
authors.lastname: Dawson
authors.affiliation: Department of Orthopaedics, Aberdeen Royal Infirmary, University of Aberdeen, Aberdeen, United Kingdom.
authors.forename: J D
authors.initials: JD
authors.lastname: Hutchison
authors.affiliation: Department of Orthopaedics, Deakin University Warrnambool Clinical School, Warrnambool, Victoria, Australia.
authors.forename: A G
authors.initials: AG
authors.lastname: Sutherland
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012421:Rupture; D011795:Surveys and Questionnaires