Trial Shows Discovery In Acute ACL Injury Treatment
July 30, 2010 11:11am EST
-William Anders
July
22, 2010- A young adult suffering from a torn anterior cruciate
ligament, otherwise known as an acute ACL injury, enters a hospital with
no optimal treatment clearly defined. Such an injury to one of the four
major knee ligaments is serious and, beginning from the tear of the
knee to rehabilitation and possible surgery, is a process that may take
months.
A new randomized trial published in the New English Journal of Medicine, conducted by Richard
B. Frobell, Ph.D., Ewa M. Roos, P.T., Ph.D., Harald P. Roos, M.D.,
Ph.D., Jonas Ranstam, Ph.D., and L. Stefan Lohmander, M.D., Ph.D.
studied two possible paths of treatments for an acute ACL injury. The
long lasting debate in ACL injury treatment is whether ACL
reconstruction surgery is necessary. In the trial, the research team
studied 121 young and active adults with acute ACL injury, attempting to
empirically test the debate, hoping to determine whether rehabilitation
plus early ACL reconstruction is superior to rehabilitation plus
optional delayed ACL reconstruction. The team noted the change in
average score on four different subscales of the KOOS score, a value
that measures the patient's opinion of the injury, in pain, symptoms,
function in sports, and quality of life (where 0 is the worst and 100 is
the best)
The
team found that, while the 59 subjects assigned to delayed ACL
reconstruction surgery experienced a higher change in KOOS score than
the 62 assigned to early ACL reconstruction surgery, the difference in
point value was only 0.2. As a result, neither path of treatment was
superior. The difference, then, is the amount of individual who
underwent surgery. As the delayed ACL reconstruction surgery was
optional, only 23 out of 59 underwent surgery, while the other 36 went
through rehabilitation without surgery.
Application
of the trial lies in the potential options that young adults suffering
from acute ACL injury have. Instead of the oft prescribed path of
rehabilitation and early ACL reconstruction, patients now know that a
delayed reconstruction, along with rehabilitation, can lead to optimal
results with a lower chance for invasive surgical reconstruction.
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