27/07/2020
Experts agree on ACL management.
Fascinating look at consensus agreement on ACL injury from British Journal of Sports Medicine (BJSM).
Expert clinicians (and one researcher) reviewed 13 statements on ACL injury in a consensus meeting in 2019. 11 out of 12 statements were agreed upon, 10 of which were unanimously agreed upon.
Statements that received 100% agreement:
1️⃣ Operative and non-operative treatments are both acceptable treatment options for ACL injury.
2️⃣ The (injury) status of other stabilising and supporting structures (eg, meniscus, other ligaments, cartilage) affects the decision to pursue operative or non-operative treatment.
3️⃣ After an ACL injury, patients may be offered a period of progressive rehabilitation to improve impairments and improve overall function.
4️⃣ An individual presenting with instability in their desired activity despite optimal rehabilitation should be referred for operative treatment.
5️⃣ Development of osteoarthritis after an ACL injury is multifactorial and evidence is inconclusive following operative or non-operative treatment.
6️⃣ In active patients wishing to return to jumping, cutting and pivoting sports (eg, soccer, football, handball, basketball): Operative treatment is the preferred option to maintain athletic participation in the medium to long term (1 to 5+ years after injury).
7️⃣ In active patients wishing to return to jumping, cutting and pivoting sports (eg, soccer, football, handball, basketball): Return to cutting and pivoting sports without surgery places the knee at risk of secondary injury (meniscus, cartilage, etc).
8️⃣ In active patients wishing to return to straight plane activities (eg, running, cycling, swimming, weightlifting, etc): Non-operative treatment is an option. 100%
9️⃣ In active patients wishing to return to straight plane activities (eg, running, cycling, swimming, weight-lifting, etc): In the case of persistent instability in daily life, operative treatment is appropriate for a return to non-rotational activities.
Statements with