ACL injuries: operative vs. non operative treatment. Follow-up at five years

Abstract

The purpose of this study was to provide evaluation elements for an objective therapeutic choice between operative and nonoperative treatment in anterior cruciate ligament (ACL) injuries in two comparable groups. Between 1992 and 1993, we examined 509 patients aged between 15 and 40 years, who had suffered knee joint injuries, resulting in isolated lesion of ACL. Between 1997 and 1998, 50 patients submitted to functional treatment and 50 operated patients were submitted to clinical, functional and instrumental tests by two operators. The evaluation criteria were the same for both groups and were based on 12 parameters: Results indicate that operation shows a statistically significant superiority in those parameters related to subjectivity, subsequent meniscal lesions, KT 1000, KAT 2000, IKDC and getting back to sports practice, whereas the difference does not appear statistically significant for patellofemoral chondropathy and radiological findings. There is no difference in articularity. Quadriceps tonotrophism is the only parameter favourable to nonoperative treatment.