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Surgery for ACL Injury Not Needed, Study Suggests

A team of researchers from Lund University in Sweden, led by Richard Frobell, revealed that intense rehabilitation could do just as well for people who have knee ligament injuries. Mr. Frobell adds that an acute ACL injury should begin with a structured rehabilitation program rather than resorting to an early ACL reconstruction surgery.

There are about 200,000 ACL reconstructions in the US, costing billions of dollars annually. Mr. Frobell said these surgical procedures could be reduced by half if ACL injury treatments would focus on rehabilitation first.

The researchers took in about 120 individuals aged 18 to 35. Half of these test subjects received reconstruction surgery treatment while the others underwent rehabilitation. After two years, the surgery group was not any better than the rehabilitation group. “Surgical reconstruction was avoided in 61 percent of the subjects without compromising the results,” the researchers said.

Dr. Bruce Levy of the Mayo Clinic also commented that treatment of ACL injury should be tailored for each individual. “It confirms what we have always intuitively thought and known and that is that not all patients need their ACLs reconstructed and that the decision to perform an ACL reconstruction really needs to be individually tailored.”

While he concurred with Frobell’s proposition for rehabilitation, Dr. Levy cautioned that delays in reconstruction due to presurgery evaluations could pose a risk for more damage to the other parts in the knee. Dr. Levy, however, acknowledges the fact that identifying which patient needs surgery is hard to predict and that more data is needed.

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