Based on these findings, one can conclude that ACL reconstruction does not guarantee restoration of normal knee function and protection to long-term disadvantages. 10 Furthermore, Ardern et al 11 found that only 55% of athletes who underwent an ACL reconstruction return to their preinjury sport level. A recent meta-analysis showed that about 50% of the patients who underwent surgical repair of their ACL have cartilage degeneration 20 years after surgery 9 and up to 23% suffer a new ACL injury (ipsilateral or contralateral) within 2 years after return to sport. 7 8 However, evidence assessing treatment outcomes after ACL reconstruction does not support these beliefs.
1 For years, it was believed that surgical repair of the ACL is necessary to restore mechanical knee stability in order to safely return to sport 5 and to avoid long-term disadvantages such as persistent knee instability, reinjury 6 and post-traumatic knee osteoarthritis. The standard care for ACL injuries includes reconstructive surgery. 3 The rupture of the ACL and damage to other knee stabilising structures often results in knee joint instability affecting daily activities and sports, leading to poor knee-related quality of life. 2 Frequently, additional injuries to the menisci, cartilage, collateral ligaments or subchondral bone are present.
These pilot findings will help deciding about progressing to a future full RCT.Īn anterior cruciate ligament (ACL) rupture is a common injury, especially in young, physically active individuals, with an annual incidence of approximately 7/10 000 persons in the general population. Therefore, this pilot study will assess whether a large RCT is feasible with regard to participant recruitment, adherence to the allocated treatment arm and protocol feasibility. This is because recruitment may be challenging as many patients have strong treatment beliefs. However, before running a full RCT, it seems necessary to perform a pilot study that assesses the feasibility of recruiting patients with ACL for such a RCT. More research is needed to in the first place verify these results, and second to assess whether patient-specific parameters determine whether a patient would benefit from one treatment option over the other. However, two randomised controlled trials (RCTs) concluded that conservative treatment does not result in inferior clinical outcomes compared with immediate ACL reconstruction. Introduction Standard care for anterior cruciate ligament (ACL) injuries includes surgical reconstruction of the ACL. 8 Leuven Biostatistics and Statistical Bioinformatics Centre, KU Leuven, Leuven, Belgium.
7 Department of Sports and Rehabilitation Sciences, University of Liège, Liège, Belgium.6 Department of Orthopedic Surgery, University Hospital of Liège, Liège, Belgium.5 Department of Physical Medicine and Sports Traumatology, Unversity Hospital of Liège, Liège, Belgium.4 Department of Orthopedics, University Hospitals Leuven, Leuven, Belgium.3 Department of Development and Regeneration, KU Leuven, Leuven, Belgium.2 Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.1 Department of Rehabilitation Sciences & Physiotherapy, KU Leuven, Leuven, Belgium.