Benefits of Implementation
Lower risk patients, based on activity and/or index laxity criteria, may tolerate an ACL deficient knee, and therefore may be spared exposure to the risks of surgical intervention such as infection, risks of anesthesia, arthrofibrosis, etc.
Possible Harms of Implementation
Despite being categorized as low risk, these patients may still require late ACL reconstruction and/or meniscal surgery and could sustain further damage to the ACL deficient knee
Future research should attempt to define which patients may be safely treated conservatively after ACL injury, and what specific risk factors contribute to this decision making process.
- (24) Daniel DM, Stone ML, Dobson BE, Fithian DC, Rossman DJ, Kaufman KR. Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med 1994;22:632-644.
- (29) Fink C, Hoser C, Hackl W, Navarro RA, Benedetto KP. Long-term outcome of operative or nonoperative treatment of anterior cruciate ligament rupture--is sports activity a determining variable? Int J Sports Med 2001;22:304-309.
- (31) Fithian DC, Paxton EW, Stone ML et al. Prospective trial of a treatment algorithm for the management of the anterior cruciate ligament-injured knee. Am J Sports Med 2005;33:335-346.
- (71) Mihelic R, Jurdana H, Jotanovic Z, Madjarevic T, Tudor A. Long-term results of anterior cruciate ligament reconstruction: a comparison with non-operative treatment with a follow-up of 17-20 years. Int Orthop 2011;35:1093-1097.
- (93) Richter M, Bosch U, Wippermann B, Hofmann A, Krettek C. Comparison of surgical repair or reconstruction of the cruciate ligaments versus nonsurgical treatment in patients with traumatic knee dislocations. Am J Sports Med 2002;30:718-727.