Non-operative management of a complete anterior cruciate ligament injury in an English Premier League football player with return to play in less than 8 weeks: applying common sense in the absence of evidence.
This case report illustrates and discusses the non-operative management of a complete anterior cruciate ligament (ACL) injury in an English Premier League football player, his return to play within 8 weeks and problem-free follow-up at 18 months post injury. When non-operative verses surgical ACL reconstruction is considered there are many fundamental gaps in our knowledge and currently, at elite level, there are no cases in cutting sports within the literature to guide these decisions. When the norm is for all professional footballers to be recommended surgery, it will be very challenging when circumstances and patient autonomy dictate a conservative approach, where prognosis, end points and risk are unclear and assumed to be high. This case challenges current dogma and provides a starting point for much needed debate about best practice, treatment options, research direction and not just at the elite level of sport.
Department of Sport Medicine and Science, West Ham United Football Club Training Ground, Chadwell Heath, Essex, UK UCL Institute of Sport, Exercise & Health and University College London Hospitals NHS Foundation Trust, London, UK The FA Centre for Disability Football Research, Burton-Upon-Trent, UK.
Richard
R
Weiler
University of Hertfordshire, Hatfield, UK.
Mathew
M
Monte-Colombo
Department of Radiology, Imperial College, London, UK.
Adam
A
Mitchell
UCL Institute of Sport, Exercise & Health and University College London Hospitals NHS Foundation Trust, London, UK.
Fares
F
Haddad
D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D004739:England; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010358:Patient Participation; D057240:Patient Preference; D055070:Resistance Training / Q000379:methods; D000068958:Return to Sport; D012916:Soccer / Q000293:injuries*; D013997:Time Factors