Trial reportBritish journal of sports medicine2023
Evidence of ACL healing on MRI following ACL rupture treated with rehabilitation alone may be associated with better patient-reported outcomes: a secondary analysis from the KANON trial.
Trial report in British journal of sports medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- No Difference in Return-to-Sport Rate or Activity Level in People with Anterior Cruciate Ligament (ACL) Injury Managed with ACL Reconstruction or Rehabilitation Alone: A Systematic Review and Meta-Analysis.Sports medicine (Auckland, N.Z.) · 2025Pooled it
- Non-surgical treatment of anterior cruciate ligament tears with percutaneous bone marrow concentrate and platelet products versus exercise therapy: a randomized-controlled, crossover trial with 2-year follow-up.BMC musculoskeletal disorders · 2025Trial
- Clinical and MRI Restoration of ACL Continuity Following Functional Complete ACL Rupture in an Adolescent Athlete: A Case Report.Clinical case reports · 2026Article
- Magnetic Resonance Imaging Assessment of Bridge-Enhanced ACL Restoration: An Imaging Atlas of Morphological Features and Healing Trajectories.Orthopaedic journal of sports medicine · 2026Article
- Non-Operative Management of a Complete ACL Rupture With the Cross-Bracing Protocol in an Elite Australian Rules Football Athlete.Clinical case reports · 2026Article
- Pass Rates of Return to Sport Test Batteries Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis.Sports (Basel, Switzerland) · 2026Review
- Surgical Versus Rehabilitation-First Management Strategies After ACL Injury: Persisting Uncertainty over Long-Term Outcomes-A Systematic Search and Narrative Synthesis of Randomized Trial Cohorts.Healthcare (Basel, Switzerland) · 2026Review
- Mid-Term Tibial Tunnel Enlargement and Graft Maturation After ACL Reconstruction: A 5-Year Follow-Up Linking Morphological Dynamics to Knee Function.Orthopaedic surgery · 2026Article
- Primary Arthroscopic Repair of Chronic Anterior Cruciate Ligament Tears.Arthroscopy techniques · 2025Article
- Mechanical cues enhance chondrocyte function: Insights from mechanoreception, regulation, and biological responses.Mechanobiology in medicine · 2025Review
- The feasibility of conducting a randomized controlled trial that compares immediate versus optional delayed surgical repair for treatment of acute Anterior cruciate ligament injury-results of the IODA pilot trial.Pilot and feasibility studies · 2025Article
- The Lever Sign Test Demonstrates Limited Clinical Utility for Diagnosing Full-Thickness Anterior Cruciate Ligament Tears After a Traumatic Knee Injury.Orthopaedic journal of sports medicine · 2025Article
- ACL Pacinian mechanoreceptors: Conceptualizing a vasoregulatory microtrauma healing function.Journal of experimental orthopaedics · 2025Article
- Digital hand-held arthrometry is a reliable and accurate adjunct for diagnosing acute anterior cruciate ligament tears.Journal of experimental orthopaedics · 2025Article
- Positive impact of patient participation in arthroscopic anterior cruciate ligament reconstruction surgery on clinical and functional outcomes, rehabilitation and patient satisfaction.BMC musculoskeletal disorders · 2025Article
- Primary repair of proximal anterior cruciate ligament injury: a global expert consensus statement.Burns & trauma · 2025Article
- Acute anterior cruciate ligament injuries can be repaired through conservative treatment with early protective motion: a single-group cohort study.BMJ open sport & exercise medicine · 2025Article
- Observational
- Primary anterior cruciate ligament repair-morphological and quantitative assessment by 7-T MRI and clinical outcome after 1.5 years.European radiology · 2024Article
- A slight degree of osteoarthritis appears to be present after anterior cruciate ligament reconstruction compared with contralateral healthy knees at a minimum of 20 years: A systematic review of the literature.Journal of experimental orthopaedics · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEvaluate the natural course of anterior cruciate ligament (ACL) healing on MRI within 5 years of acute ACL rupture and compare 2-year and 5-year outcomes based on healing status and treatment group.
methodsSecondary analysis of 120 Knee Anterior Cruciate Ligament Nonsurgical vs Surgical Treatment (KANON) trial participants randomised to rehabilitation and optional delayed ACL reconstruction (ACLR) or early ACLR and rehabilitation. ACL continuity on MRI (Anterior Cruciate Ligament OsteoArthritis Score 0-2) was considered evidence of ACL healing. Outcomes included Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS patient acceptable symptomatic state (PASS) and treatment failure criteria. Linear mixed models were used to estimate adjusted mean differences (95% CIs) in patient-reported sport and recreational function (KOOS-Sport/Rec) and quality of life (KOOS-QOL) at 2 and 5 years, between participants with MRI evidence of ACL healing and those who had (1) no evidence of ACL healing, (2) delayed ACLR or (3) early ACLR.
resultsMRI evidence of ACL healing at 2-year follow-up was observed in 16 of 54 (30%, 95% CI 19 to 43%) participants randomised to optional delayed ACLR. Excluding participants who had delayed ACLR, 16 of 30 (53%, 36-70%) participants managed with rehabilitation-alone displayed MRI evidence of ACL healing. Two-year outcomes were better in the healed ACL group (n=16) compared with the non-healed (n=14) (mean difference (95% CI) KOOS-Sport/Rec: 25.1 (8.6-41.5); KOOS-QOL: 27.5 (13.2-41.8)), delayed ACLR (n=24) (KOOS-Sport/Rec: 24.9 (10.2-39.6); KOOS-QOL: 18.1 (5.4-30.8)) and early ACLR (n=62) (KOOS-Sport/Rec: 17.4 (4.1-30.7); KOOS-QOL: 11.4 (0.0-22.9)) groups. Five-year KOOS-QOL was better in the healed versus non-healed group (25.3 (9.4-41.2)). Of participants with MRI evidence of ACL healing, 63-94% met the PASS criteria for each KOOS subscale, compared with 29-61% in the non-healed or reconstructed groups.
conclusionsMRI appearance of ACL healing after ACL rupture occurred in one in three adults randomised to initial rehabilitation and one in two who did not cross-over to delayed ACLR and was associated with favourable outcomes. The potential for spontaneous healing of the ACL to facilitate better clinical outcomes may be greater than previously considered. TRIAL REGISTRATION NUMBER: ISRCTN84752559.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.