Does early ACL construction give superior results?

by Today in PT

Reported in August 16,2010 Today in PT Magazine

Early ACL Reconstruction Not Superior to Delayed

In young, active adults with acute anterior cruciate ligament tears, a strategy of rehabilitation plus early ACL reconstruction was not superior to a strategy of rehabilitation plus optional delayed ACL reconstruction, according to a randomized, controlled trial by Lund (Sweden) University researchers. The latter strategy substantially reduced the frequency of surgical reconstructions.

The primary outcome of the trial, involving 121 young, active adults with acute ACL injuries, was the change from baseline to two years in the average score on four subscales of the Knee Injury and Osteoarthritis Outcome Score — pain, symptoms, function in sports and recreation, and knee-related quality of life (range of scores, 0 worst to 100 best).

Of 62 subjects assigned to rehabilitation plus early ACL reconstruction, one did not undergo surgery. Of 59 assigned to rehabilitation plus optional delayed ACL reconstruction, 23 underwent delayed ACL reconstruction; the other 36 underwent rehabilitation alone. The absolute change in the mean KOOS4 score was 39.2 points for those assigned to rehabilitation plus early ACL reconstruction and 39.4 for those assigned to rehabilitation plus optional delayed reconstruction.