Who Needs ACL Surgery? An Open Question

Lynn Snyder-Mackler, May Arna Risberg

DOI: 10.2519/jospt.2011.0108

Anterior cruciate ligament (ACL) injuries commonly occur with negative sequelae, including reduced activity in the short term and threats to long-term knee health. Nonoperative management of highly active individuals after ACL rupture is controversial. A recent randomized controlled trial, comparing structured rehabilitation and early surgery with structured rehabilitation and optional delayed surgery, demonstrated no significant differences between the 2 groups in patients' self-reported knee function 2 years after inclusion. Work identifying individuals with an anterior cruciate ligament-deficient knee as copers and noncopers demonstrates considerable potential for success of nonoperative treatment in selected patients. However, the story is still incomplete. Many questions still need to be answered before we can prospectively, and with strong predictive ability, identify patients who can regain knee function with structured rehabilitation and no reconstructive surgery.

J Orthop Sports Phys Ther 2011;41(10):706-707. doi:10.2519/jospt.2011.0108

KEY WORDS: anterior cruciate ligament, copers, noncopers

Many questions still need to be answered before we can prospectively, and with strong predictive ability, identify patients with anterior cruciate ligament (ACL) injuries who can regain knee function with structured rehabilitation and no reconstructive surgery.

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