ArticleThe American journal of sports medicine2018
Does Anterior Cruciate Ligament Reconstruction Improve Functional and Radiographic Outcomes Over Nonoperative Management 5 Years After Injury?
Article in The American journal of sports medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Reconstruction After an Anterior Cruciate Ligament Injury Does Not Reduce the Osteoarthritis Risk But Lowers the Total Knee Arthroplasty Rate: A Systematic Review and Meta-analysis.Orthopaedic journal of sports medicine · 2026Review
- Clinical Outcome of Femoral Suspensory Fixation for Anterior Cruciate Ligament (ACL) Reconstruction.Cureus · 2025Article
- The increased lateral tibial slope may result in inferior long-term clinical outcome after DB-ACL reconstruction.Archives of orthopaedic and trauma surgery · 2024Article
- Lower Patellofemoral Joint Contact Force During Side-Step Cutting After Return-to-Sports Clearance Following Anterior Cruciate Ligament Reconstruction.The American journal of sports medicine · 2023Article
- Predicting anterior cruciate ligament failure load with TScientific reports · 2023Article
- Quantitative MRI Biomarkers to Predict Risk of Reinjury Within 2 Years After Bridge-Enhanced ACL Restoration.The American journal of sports medicine · 2023Article
- Article
- A comparison of preoperative scores prior to anterior cruciate ligament reconstruction with optimal preinjury scores and final scores at two-year follow up.Bone & joint open · 2023Article
- Current trends in the anterior cruciate ligament part II: evaluation, surgical technique, prevention, and rehabilitation.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Review
- Impact of Rehabilitation on Gait Kinematic following Grade II Anterior Cruciate Ligament Injury among Wrestlers.BioMed research international · 2022Article
- The top 100 most impactful articles on the anterior cruciate ligament: An altmetric analysis of online media.SAGE open medicine · 2022Article
- Joint effusion, anteroposterior stability, muscle strength and degree of patellofemoral osteoarthritis significantly impact outcome following revision ACL reconstruction.Journal of experimental orthopaedics · 2021Article
- Article
- Operative and nonoperative management of anterior cruciate ligament injury: Differences in gait biomechanics at 5 years.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2020Article
- Surgical versus conservative treatment for torn anterior cruciate ligament.Joint diseases and related surgery · 2020Article
- Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture.Best practice & research. Clinical rheumatology · 2019Review
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundCurrent practice patterns for the management of anterior cruciate ligament (ACL) injury favor surgical reconstruction. However, long-term outcomes may not differ between patients completing operative and nonoperative treatment of ACL injury. Differences in outcomes between operative and nonoperative treatment of patients in the United States is largely unknown, as are outcomes in long-term strength and performance measures. PURPOSE: To determine if differences exist in 5-year functional and radiographic outcomes between patients completing operative and nonoperative treatment of ACL injury when both groups complete a progressive criterion-based rehabilitation protocol. STUDY
designCohort study; Level of evidence, 2.
methodsFrom an original group of 144 athletes, 105 participants (mean ± SD age, 34.3 ± 11.4 years) with an acute ACL rupture completed functional testing (quadriceps strength, single-legged hop, and knee joint effusion testing; patient-reported outcomes) and knee radiographs 5 years after ACL reconstruction or completion of nonoperative rehabilitation.
resultsAt 5 years, patients treated with ACL reconstruction versus rehabilitation alone did not differ in quadriceps strength ( P = .817); performance on single-legged hop tests ( P = .234-.955); activity level ( P = .349-.400); subjective reports of pain, symptoms, activities of daily living, and knee-related quality of life ( P = .090-.941); or presence of knee osteoarthritis ( P = .102-.978). When compared with patients treated nonoperatively, patients treated operatively did report greater global ratings of knee function ( P = .001), and lower fear ( P = .035) at 5 years but were more likely to possess knee joint effusion ( P = .016).
conclusionThe current findings indicate that favorable outcomes can occur after both operative and nonoperative management approaches with the use of progressive criterion-based rehabilitation. Further study is needed to determine clinical algorithms for identifying the best candidates for surgical versus nonoperative care after ACL injury. These findings provide an opportunity to improve the educational process between patients and clinicians regarding the expected clinical course and long-term outcomes of operative and nonoperative treatment of ACL injuries.
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