Surgical Versus Non-Surgical Treatment for an Injury to the Anterior Cruciate Ligament: A Structured Literature Review.
Item
- Title
- Surgical Versus Non-Surgical Treatment for an Injury to the Anterior Cruciate Ligament: A Structured Literature Review.
- Author(s)
- Everest, A
- Abstract
- Background ACL injury is a frequently occurring knee injury, commonly in active, female individuals, aged 15-40 years old. Patients are diagnosed via MRI, orthopaedic testing and occasionally arthroscopy. The injury leads to instability, swelling and locking sensations. ACL-deficient patients will either undergo surgical and rehabilitative treatment or rehabilitative treatment alone; part of the decision to perform ACLR depends on the level of knee instability. Objectives This research was conducted to critically appraise the current literature to provide a conclusion of the most appropriate management strategy for ACL injuries. Furthermore, to answer the research question: “In terms of patient-reported knee function, which treatment is most suitable for patients with an ACL-deficient knee – surgical or conservative treatment?” Design Structured Literature Review. Method Four databases were utilised to source current literature. Search terms were applied and the results were screened, the inclusion and exclusion criteria were then applied. Data was extrapolated from the recruited studies in order to meet the proposed aims and objectives. Results and methodological quality were reported. A single researcher conducted a quality assessment of the recruited studies using the authorised CMS tool. Results Thirteen studies were selected with a mean CMS of 62.54/100, thus suggesting fair study quality. KOOS subscores were the most frequently occurring patient-reported outcomes. Small differences were reported between mean values of patient-reported outcomes; however, following data manipulation, minimal significant differences between surgical and conservative ACL treatment were reported. Discussion ACLR offers greater tibiofemoral stability; however, there are no significant differences in patient-reported outcomes between surgical and conservative treatment. Initial rehabilitation improves post-operative outcomes and can decrease the likelihood of knee OA. Mean CMS demonstrates the included studies are of fair quality, which is similar in cartilage repair studies, thus suggesting the suitability of the CMS for application to ACL studies. More RCTs reporting patient-reported outcome measures are required in order to determine superiority of treatment strategies for ACL injury. Conclusion The current literature proposes small difference in patient-reported outcomes between surgical and conservative ACL treatment; outcomes can be reliant upon patient compliance. The patient-reported outcomes assessment tools are vital to rehabilitation as it provides a gauge for patient improvement.
- presented at
- European School of Osteopathy
- Date Accepted
- 2019
- Date Submitted
- 19.11.2019 18:31:07
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 16494
- Inst-Identifier
- 1229
- Keywords
- ACL conservative treatment, ACL injury, ACL surgical treatment, Patient-reported outcomes.
- Recommended
- 0
- Item sets
- Thesis
Everest, A, “Surgical Versus Non-Surgical Treatment for an Injury to the Anterior Cruciate Ligament: A Structured Literature Review.”, Osteopathic Research Web, accessed May 4, 2025, https://www.osteopathicresearch.org/s/orw/item/335