Australia (Commonwealth Union) – Common knee injuries occurs in the Anterior Cruciate Ligament (ACL). ACL reconstruction is carried out by taking out the torn ACL and replacing it with tissue generally from the hamstring or patella tendon, usually an attempt to copy the native ACL. In Australia, Europe and the United States, ACL generally have reconstruction surgery treatment for ACL ruptures, and surgery rates are surging. A new study has indicated that ACLs healed better following exercise-based rehabilitation in comparison to surgery.
The research discovered that 53% of trial participants whose ACL ruptures were handled just with rehabilitation, and had no surgery, had a healed ACL on MRI 2 years following injury. Signs of ACL recovery were noticed as early as 3 months following injury on MRI in this group.
Physiotherapist and Senior Research Fellow at the University of Melbourne, Dr Stephanie Filbay who led the study, stated that most individuals with ACL injury experience continuous sport and activity restrictions, extra surgeries for knee injuries, continuous pain, early initiations of knee osteoarthritis and quality of life badly effected regardless of management with rehabilitation only or ACL reconstruction. She noted that it is known that certain individuals do extremely well with rehabilitation and others require surgery, however our ability to forecast who will do well or why has been minimal.
“Interestingly, very few people who decided to have delayed surgery had a healed ACL on 3-month MRI. No one in our study was aware of the healing status of their ACL, so this did not influence their decision to have surgery. This suggests the healing status of the ACL may be important in determining who will have a successful outcome following rehabilitation,” Dr. Filbay said.
Limited studies into the chances of ACL healing and the association between ACL healing on MRI and patient outcomes is most likely the reason for the general view that ACL ruptures do not heal.
