Young Active Adult
Moderate evidence supports surgical reconstruction in active young adult (18-35) patients with an ACL tear.

Rationale
The recommendation is based on one study of one prospective randomized cohort and two studies of moderate strength. 33, 34, 67, 90 The evidence indicates that ACL reconstruction decreases pathologic laxity, as measured by the Lachman, KT-1000, and pivot shift tests, and reduces episodes of instability and the incidence of subsequent injuries including meniscal tears.

Possible Harms of Implementation
As with all surgical procedures, there are patient risk including but not limited to infection, anesthetic complications, phlebitis, and neurovascular injury.

Future Research
Recommend increased attention to assessing factors important to potentially delay or prevent post-joint injury osteoarthritis such as outcomes of meniscus repair vs resection and outcomes assessing joint biology and homeostasis including restoration of normal joint biomechanics. Prospective comparative studies of nonoperative treatment and ACL reconstruction in skeletally immature patients are necessary.
 
 

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