Is ACL reconstruction a prerequisite for the patients having recreational sporting activities?

Acta Orthop Traumatol Turc. 2018 Jan;52(1):37-43. doi: 10.1016/j.aott.2017.11.010. Epub 2017 Dec 28.


Objective: Whether surgical or conservative treatment is more effective in allowing patients to return to physical activity after anterior cruciate ligament (ACL) injury is controversial. We sought to compare mid-term outcome measures between isolated ACL tear patients who underwent reconstruction followed by closed kinetic chain exercises and those who underwent neuromuscular training only.

Methods: We retrospectively evaluated patients with ACL tears who underwent post-surgery CKC strength training after ACL reconstruction (Group A), and patients who only underwent neuromuscular training (Group B) with a minimum follow-up time of 5 years. Surgical techniques, rehabilitation, assessment of subjective knee function, one-leg hop test, assessment of joint position sense, muscle strength, and the health profile of the patient were evaluated.

Results: Overall, 43 patients were included in Group A (mean age, 32.56 ± 4.89; Tegner activity scale, 5) and 39 patients in Group B (31.67 ± 7.27; 5). Patients in both groups returned to their regular physical activity level after a similar time frame (Group A: average, 12 months; Group B, average, 13.4 months). The mean Lysholm knee score was 88.52 ± 7.65 in Group A and 86.21 ± 13.72 in Group B. Mean distances for the one-leg hop test for Group A were 135.21 ± 31.66 and 145.36 ± 42.10 mm in the reconstructed and uninjured knees, respectively. In Group B, the mean hop distances were 132.47 ± 28.13 and 147.89 ± 21.45 mm in the rehabilitated and uninjured knees, respectively. No statistical difference was observed between the groups for any of the parameters evaluated, including assessment of subjective knee function, one-leg hop test, assessment of joint position sense, muscle strength, and the health profile.

Conclusion: Our data suggest that early surgical reconstruction may not be a prerequisite to returning to recreational physical activities after injury in patients with ACL tears.

Level of evidence: Level IV, therapeutic study.

Keywords: Anterior cruciate ligament; Anterior cruciate ligament reconstruction; Functional performance tests; Knee joint; Neuromuscular joint facilitation; Proprioception.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament Injuries* / surgery
  • Anterior Cruciate Ligament Injuries* / therapy
  • Anterior Cruciate Ligament Reconstruction* / methods
  • Anterior Cruciate Ligament Reconstruction* / statistics & numerical data
  • Athletic Injuries / surgery
  • Athletic Injuries / therapy
  • Conservative Treatment / methods
  • Conservative Treatment / statistics & numerical data
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Knee Joint* / innervation
  • Knee Joint* / physiopathology
  • Male
  • Outcome and Process Assessment, Health Care
  • Proprioception
  • Retrospective Studies
  • Return to Sport / statistics & numerical data*