ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019
Non-operative treatment of ACL injury is associated with opposing subjective and objective outcomes over 20 years of follow-up.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Long-term Radiographic Fate of the Chronically ACL-Deficient Knee: A Systematic Review and Meta-analysis of Matched Cohort Studies.The American journal of sports medicine · 2026Pooled it
- Clinical outcomes and complications after anterior cruciate ligament reconstruction with bone-patellar tendon-bone in patient Tanner 3 and 4: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Pooled it
- Comparison of postoperative knee osteoarthritis after isolated anatomical single bundle and transtibial anterior cruciate ligament reconstruction : A 10-16-year comparative study.Orthopadie (Heidelberg, Germany) · 2026Article
- Sport-specific differences in ACL injury, treatment and return to sports: Football.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Review
- High posterior tibial slope is associated with higher failure rates in nonoperative management of primary anterior cruciate ligament injury.Journal of experimental orthopaedics · 2025Article
- Predicting ACL Reconstruction Failure with Machine Learning: Development of Machine Learning Prediction Models.Orthopaedic journal of sports medicine · 2025Article
- Anterior Cruciate Ligament Reconstruction with Internal Brace Augmentation Results in Fewer Reruptures Compared to Reconstruction without Augmentation.Revista brasileira de ortopedia · 2024Article
- Review
- Anterior Cruciate Ligament Tear: Individualized Indications for Non-Operative Management.Journal of clinical medicine · 2024Review
- Outcomes >30 Years After Initial Nonoperative Treatment of Anterior Cruciate Ligament Injuries.The American journal of sports medicine · 2024Article
- Risk Factors for Symptomatic Cyclops Lesion Formation after Anterior Cruciate Ligament Reconstruction.Revista brasileira de ortopedia · 2023Article
- Is Insurance Status Associated With Likelihood of Operative ACL Injury Treatment Compared With Nonoperative Treatment?Orthopaedic journal of sports medicine · 2022Article
- 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
- Patients Aged 50 Years and Older Have Greater Complication Rates After Anterior Cruciate Ligament Reconstruction: A Large Database Study.Arthroscopy, sports medicine, and rehabilitation · 2021Article
- Acute ACL reconstruction shows superior clinical results and can be performed safely without an increased risk of developing arthrofibrosis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Does posterior tibial slope affect the results of conservative treatment for anterior cruciate ligament tears?International orthopaedics · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was the evaluation of long-term clinical and radiological outcomes of non-operative treatment of anterior cruciate ligament (ACL) deficiency. The hypothesis was that conservative treatment would be associated with a deterioration of subjective and objective measures of joint health and disability over time.
methodsFrom an initial sample of 41 patients conservatively treated for ACL rupture, 10 received secondary ACL reconstruction, 1 was excluded due to contralateral ACL injury, and 1 patient required total knee replacement and a high tibial osteotomy. Seven further patients were lost to follow-up. The remaining 21 patients (15 male, 6 female, mean age 53.1 ± 9.2 years at the last follow-up) were evaluated by the same two examiners 5-7, 10-13 and 20-22 years after the injury. The evaluation was based on objective and subjective scores, instrumented testing, radiographic examination and assessment of sports activity.
resultsWhile subjective patient satisfaction improved over time, objective scores stayed constant or deteriorated (radiologic evaluation). Instrumented knee laxity testing showed an initial tendency to increasing instability, followed by a decrease in anterior tibial translation in the second half of the observation period. Physical activity levels, particularly in high-risk sports, decreased significantly (p < 0.05) compared to preinjury levels. All patients developed significant arthritic degenerative changes over time compared to the uninjured contralateral knee. No correlation to activities in high- or low-risk pivoting sports was found.
conclusionsPatient satisfaction with conservative treatment of ACL injuries is good in spite of objective measures indicating increasing degenerative changes. LEVEL OF EVIDENCE: IV.
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