Surgery vs Conservative Treatment

1 Introduction
2 Hamstring vs Patella Tedon Graft Rehabilitation >
3 Effects of Removing Part of the Tendon >
4 Suitability of Hamstring and Patella Grafts >
5 Surgery vs Conservative Treatment

Is surgery always necessary following ACL rupture? How effective is conservative treatment?

"The question of whether surgery is necessary or not is somewhat of a contentious one. To date, no one has carried out appropriately balanced randomised controlled trials to answer this question. The commonest reason given for undertaking surgery is to reduce the risk of future joint degeneration. Interestingly, recent prospective surveys (e.g. Myklebust et al. 2003, American Journal of Sports Medicine) have shown that whether or not surgery is undertaken for ACL injury the joint degenerates significantly more than in uninjured players. The same study also showed that regardless of intervention the majority of patients returned to elite level sport.

"The other reason given for surgical repair is to stabilise the joint. It must be remembered that mechanically speaking, the ACL is an incredibly complex structure and the grafts used to reconstruct it are very poor substitutes for the original. They lack the multi-band nature of the original which gives it isometric strength throughout knee movement, creating tension in some part of the ligament through the whole range of knee movement. This not only provides stability but also proprioceptive feedback. This would appear to indicate that only if the patient is neuromuscularly re-trained will the joint have any hope of becoming functionally stable, regardless of whether or not it is operated on.

Numerous studies have shown that the ACL reconstructed, or ACL deficient, patients fail to have the longevity in sport of their peers and, as mentioned above, have considerably greater joint degradation. The challenge to those in sports rehabilitation is to rehabilitate these players in such a way that they can not only return to sport, but perform as well as before with a longevity to their careers comparative to their peers and without long-term joint damage. It is for the researchers in this field to identify those players who can adapt to ACL injury (with or without surgery) and return to an uncompromised sporting career and recognise those players whose injury is the precursor to long term joint degeneration and poor functional outcome."

Recommended Products for ACL Knee Injury & Reconstruction

ACL Knee Braces & Supports

Mueller Pro Style Hinged Knee Brace (deluxe)

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Donjoy Armor with Fourcepoint Knee Brace

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Mueller Hg80 Hinged Knee Brace with Kevlar

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Donjoy ACL Everyday Knee Brace

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Donjoy's most comfortable, lightweight and easy to use ACL knee brace - designed for daily living and non-contact sports....

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Donjoy Legend Knee Brace

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Ice Packs & Compression

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PhysioRoom.com Ice Bag

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Aircast Knee Cryo/Cuff (Self Contained)

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NEW!Specialist knee ice therapy device. Fill it with ice and water to...
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Arctic Blast Ice Cooling Bandage

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NEW!Instant cooling bandage that can be applied again and again. Suitable for the ankle, knee, thigh,...

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Mueller Reusable Cold/Hot Therapy Wrap (Large)

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Aircast Knee Cryo/Cuff with Cooler

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Ultimate knee ice therapy. Provides 6 hours continuous cold and compression to minimise bleeding,...
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ACL Rehabilitation Kit

AquaJogger 100 Floatation Belt

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The AquaJogger 100 is a floatation belt. One particular benefit is that it allows an early return...
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PhysioRoom.com Swiss Ball (55cm)

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55cm (22") diameter Swiss Ball for people 155-165cm (5'2" - 5'6") tall. Includes FREE exercise chart. ...

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Sirex Monica Mat

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A durable and comfortable non-slip, red mat for Yoga, Pilates and multi-purpose exercise. Features a unique fold away design for...

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