Young Athletes Can Rehab ACL Injuries and Avoid Surgery

Young, active athletes with anterior cruciate ligament (ACL) injuries can rehabilitate their damaged knees and avoid reconstructive surgery.

In 2010, researchers from Lund University in Sweden reported that 60% of all ACL reconstructions could be avoided in favor of rehabilitation with experienced physiotherapists.

The study made waves around the world, and the results were met with concerns that they would not hold up in the long term.

Now a 5-year follow-up confirms that reconstructive surgery does not provide better results than physiotherapy, according to a new report in the British Medical Journal.

Half of the 120 patients, average age 26, were randomly assigned to early ACL reconstruction and the other half were given the option of having a delayed ACL reconstruction, if needed.

Half of the patients assigned to delayed ACL reconstruction had reconstructive surgery after experiencing symptoms of instability.

“In this study, there was no increased risk of osteoarthritis or meniscal surgery if the ACL injury was treated with physiotherapy alone compared with if it was treated with surgery.

Neither was there any difference in patients’ experiences of function, activity level, quality of life, pain, symptoms, or general health,” says lead author Richard Frobell.

In southern Sweden, Lund and his colleagues have been working to use advanced rehabilitation training as the first method of treatment.

“Our research so far has confirmed that we are right in not choosing to operate on these injuries immediately,” says Lund.

“These results should encourage clinicians and young active adult patients to consider rehabilitation as a primary treatment option following an acute ACL tear.”

He points out that half of the 10,000 scientific publications addressing the ACL are about surgical treatment.

However, none of these studies have shown that surgical reconstruction produces better results than rehabilitation alone.

Despite this, American surgeons perform 200,000 ACL surgeries each year.

I know that if my 19-year-old son rips up his ACL snowboarding, I will strongly suggest he rehab it before going under the knife.

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