Performance‐based functional evaluation of non‐operative and operative treatment after anterior cruciate ligament injury

Highly active anterior cruciate ligament (ACL)‐injured patients are usually recommended surgical treatment as the primary intervention. The objective of this study was to compare the functional outcome in a cohort of individuals after non‐operative treatment to individuals after surgical treatment at a 1‐year follow‐up. One hundred and twenty‐five subjects with a mean age of 27.2 years (±8.6 years), and participating in level I or II activities were included. Baseline and 1‐year follow‐up examination included four single‐legged hop tests, IKDC 2000, KOS‐ADLS, KT‐1000 knee arthrometer measurement, VAS, episodes of giving way, and activity level. Fifty‐one percent went through non‐operative treatment. Non‐operated subjects performed significantly better on two of the four single‐legged hop tests compared with the ACL‐reconstructed subjects at the 1‐year follow‐up. No other differences were observed. Both groups performed an average >90% compared with their uninjured leg on all single‐legged hop tests at the 1‐year follow‐up. The IKCD 2000 scores in the non‐operated and ACL‐reconstructed group were on average 86 and 87. ACL‐injured subjects should be informed of the possibility of success after non‐operative treatment, but future studies are needed to determine significant predictive factors for success for non‐operative and surgically treated individuals.

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