Hold the knife, try PT for ACL first.

The study is small but the results are impressive. Physiotherapy alone was as effective as surgical reconstruction plus physiotherapy for damaged ACLs in 60% of the cases.

ScienceDaily (July 22, 2010) — Anterior cruciate ligament (ACL) injuries are common injuries to the knee, primarily affecting young people who practise sport and often treated with surgical reconstruction. A research group from Lund University has now shown that 60 per cent of these operations could be avoided, without negatively affecting treatment outcomes.

The research group’s study is known as the KANON study and started in 2001. The group is publishing its results in the New England Journal of Medicine.

“In our study, patients with acute ACL injuries were randomly divided into two groups for treatment with rehabilitation plus early ACL reconstruction or rehabilitation alone with the possibility of a later operation if this was deemed necessary. After two years only 40 per cent of the latter group needed to have an ACL reconstruction…

…”There are almost 10 000 scientific publications addressing the ACL and 50 per cent of these are about surgical treatment. However, none of these studies have shown that surgical reconstruction produces better results than rehabilitation alone. Despite this, we perform 3 000 cruciate ligament reconstructions a year in Sweden,” says Stefan Lohmander, professor and consultant at Lund University and Skåne University Hospital. “In the USA there are 200 000 operations of this type, at a cost of USD 3 billion!”

The research group’s results have strengthened their conviction that there is no evidence to support the recommendation of ACL reconstruction as a first method of treatment.

for the full story click Half of All ACL reconstructions could be avoided

For info on possible negative effects of ACL surgery, click  Complications from ACL surgery

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