ArticleOrthopaedic journal of sports medicine2021
Decision Making for Treatment After ACL Injury From an Orthopaedic Surgeon and Patient Perspective: Results From the NACOX Study.
Article in Orthopaedic journal of sports medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02931084 (Natural Course and Recovery After ACL-injury), which is not on this map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Natural Course and Recovery After ACL-injury
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Primary surgery versus primary rehabilitation for treating anterior cruciate ligament injuries: a living systematic review and meta-analysis.British journal of sports medicine · 2022Pooled it
- Fear of Reinjury Following Surgical and Nonsurgical Management of Anterior Cruciate Ligament Injury: An Exploratory Analysis of the NACOX Multicenter Longitudinal Cohort Study.Physical therapy · 2022Trial
- Return to sport after primary anterior cruciate ligament reconstruction in athletes with a preinjury Tegner Activity Scale ≥7: a longitudinal, nationwide, registry-based cohort study.British journal of sports medicine · 2026Article
- The role of tendon and ligament vasculature in ageing and injury.Biogerontology · 2026Review
- Patient-Reported Knee Function and Return-to-Sport Rates After Nonsurgical and Surgical Treatment of an Acute Anterior Cruciate Ligament Injury: Results From the NACOX Prospective Cohort Study.The American journal of sports medicine · 2026Article
- FIRM-P separates knee phenotype from patient context in anterior cruciate ligament-related instability: A conceptual framework integrating arthrogenic muscle inhibition as a cross-domain modifier.Journal of experimental orthopaedics · 2026Article
- Reconstruction of a Rare Split-Level Bilaminar Patellar Tendon Rupture With Concomitant Multiligament Knee Injury Using Peroneus Longus Autograft: A Case Report.Case reports in orthopedics · 2026Article
- Identification of characteristics of patients who choose operative versus non-operative management after ACL injury: a latent class analysis.Sports medicine - open · 2025Article
- Semitendinosus vs quadriceps tendon autograft in anterior cruciate ligament reconstruction (SEQUAR): protocol for a prospective randomized controlled trial.BMC musculoskeletal disorders · 2025Article
- From Past to Future: Emergent Concepts of Anterior Cruciate Ligament Surgery and Rehabilitation.Journal of clinical medicine · 2025Review
- No differences in patient-reported outcomes (PROMs) and complications after anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BPTB) or hamstrings (HT) in patients aged 50 or older.Journal of experimental orthopaedics · 2025Article
- Treatment Decision-Making for Anterior Cruciate Ligament Rupture From the Perspective of Physical Therapists in Australia: A Mixed Methods Study.Physical therapy · 2025Article
- More knee reinjuries after ACL reconstruction compared to nonsurgical treatment of the ACL. A 2-year follow-up of the NACOX prospective cohort study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Which patients need anterior cruciate ligament reconstruction after initial treatment with rehabilitation? A scoping review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Return to Soccer After Anterior Cruciate Ligament Reconstruction: An Outcome or a Decision?Orthopaedic journal of sports medicine · 2024Article
- Anterior Cruciate Ligament Tear: Individualized Indications for Non-Operative Management.Journal of clinical medicine · 2024Review
- Knee-Related Quality of Life Compared Between 20 and 35 Years After an Anterior Cruciate Ligament Injury Treated Surgically With Primary Repair or Reconstruction, or Nonsurgically.The American journal of sports medicine · 2024Article
- Comparison of Clinical Results Using Hamstring Versus Quadriceps Tendon Graft Versus Bone Patella Tendon in Anterior Cruciate Ligament Reconstruction Surgery: A Randomized Clinical Trial.Medical journal of the Islamic Republic of Iran · 2024Article
- It is time to target psychological readiness (or lack of readiness) in return to sports after Anterior Cruciate Ligament tears.Journal of experimental orthopaedics · 2023Article
- The experience and influence of fear after anterior cruciate ligament reconstruction: an interview study with young athletes.BMC sports science, medicine & rehabilitation · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the treatment of anterior cruciate ligament (ACL) injuries, there is little evidence of when and why a decision for ACL reconstruction (ACLR) or nonoperative treatment (non-ACLR) is made. PURPOSE: To (1) describe the key characteristics of ACL injury treatment decisions and (2) compare patient-reported knee instability, function, and preinjury activity level between patients with non-ACLR and ACLR treatment decisions. STUDY
designCohort study; Level of evidence, 2.
methodsA total of 216 patients with acute ACL injury were evaluated during the first year after injury. The treatment decision was non-ACLR in 73 patients and ACLR in 143. Reasons guiding treatment decision were obtained from medical charts and questionnaires to patients and orthopaedic surgeons. Patient-reported instability and function were obtained via questionnaires and compared between patients with non-ACLR and ACLR treatment decisions. The ACLR treatment group was classified retrospectively by decision phase: acute phase (decision made between injury day and 31 days after injury), subacute phase (decision made between 32 days and up to 5 months after injury), and late phase (decision made 5-12 months after injury). Data were evaluated using descriptive statistics, and group comparisons were made using parametric or nonparametric tests as appropriate.
resultsThe main reasons for a non-ACLR treatment decision were no knee instability and no problems with knee function. The main reasons for an ACLR treatment decision were high activity demands and knee instability. Patients in the non-ACLR group were significantly older (
conclusionActivity demands, not patient-reported knee instability, may be the most important factor in the decision-making process for treatment after ACL injury. We suggest a decision-making algorithm for patients with ACL injuries and no high activity demands; waiting for >3 months can help distinguish those who need surgical intervention from those who can undergo nonoperative management. REGISTRATION: NCT02931084 (ClinicalTrials.gov identifier).
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