ACL Impactful Statements
The following impactful statements are based on the Management of Anterior Cruciate Ligament Injuries Clinical Practice Guideline.
- ACL reconstruction should be performed in young active adult patients with an ACL tear.
- ACL reconstruction, when indicated, should be performed within five months of injury to protect the articular cartilage and menisci.
- Bone-patellar tendon-bone or hamstring-tendon grafts should be used in patients undergoing intra-articular ACL reconstruction using autograft tissue, as the measured outcomes are similar.
- Functional knee bracing after isolated ACL reconstruction should not be routinely used as there is no demonstrated efficacy.
- Neuromuscular training programs could be used as they could reduce ACL injuries; however, the number of athletes needed to treat to prevent one ACL injury is very high (109)
The following recommendations are the basis of the statements above.
- Moderate evidence supports surgical reconstruction in active young adult (18-35) patients with an ACL tear.
- When ACL reconstruction is indicated, moderate evidence supports reconstruction within five months of injury to protect the articular cartilage and menisci.
- Strong evidence supports that in patients undergoing intra-articular ACL reconstruction using autograft tissue the practitioner should use bone-patellar tendon-bone or hamstring-tendon grafts, because the measured outcomes are similar.
- Moderate evidence does not support the routine use of functional knee bracing after isolated ACL reconstruction, because there is no demonstrated efficacy.
- Moderate strength evidence from pooled analyses with a small effect size (Number Needed to Treat=109) supports that neuromuscular training programs could reduce ACL injuries.