ACL reconstruction rates are on the rise in Australia, but is that a good thing?

Our current understanding of ACL rehabilitation would suggest maybe not. [1] [2]

Most people’s experience with ACL injuries is watching footy players go down in a game and not seeing them on the field again for a year. These players generally get surgery and then follow a course of rehab for 12 months.

But what if there was another option?

Current research around the reconstruction of Anterior Cruciate Ligaments has been comparing the benefits and long term outcomes of a conservative strength and conditioning program against early surgery followed by rehabilitation. [3]

These studies are suggesting that a routine surgical repair of every ACL injury is probably unnecessary, and possibly unwise. Undertaking a rehabilitation program early has benefits on long term outcomes and if you need surgery down the track you will probably be better off having done some prehab.

Not to say that the surgery is completely useless, on the contrary. In certain circumstances ACL reconstruction be absolutely required, but it is important to know what those circumstances are and what the alternative involves.

Questions to ask yourself if you are experiencing substantial knee pain:

  • Can I walk around and participate in my normal activities?
  • Do I have adequate movement at the knee?
  • Can I bend and squat down?
  • Do I want to avoid an invasive surgery and potentially extensive time off work?

If you answered yes to some of these questions then what should you do?

First off, get assessed by a physiotherapist who can figure out what you want and what you need. They will then get you started on a solid progressive rehab program that is targeted at your specific requirements.

If you want to find out more about how to get back on track without surgery, or to make a more informed decision, then come see me at Life Ready Physio Midland and have a chat.

 

[1] Filbay, S. R., Roos, E. M., Frobell, R. B., Roemer, F., Ranstam, J., & Lohmander, L. S. (2017). Delaying ACL reconstruction and treating with exercise therapy alone may alter prognostic factors for 5-year outcome: an exploratory analysis of the KANON trial. Br J Sports Med, bjsports-2016.
[2] Smith, T. O., Postle, K., Penny, F., McNamara, I., & Mann, C. J. V. (2014). Is reconstruction the best management strategy for anterior cruciate ligament rupture? A systematic review and meta-analysis comparing anterior cruciate ligament reconstruction versus non-operative treatment. The Knee21(2), 462-470.
[3] Nordenvall, R., Bahmanyar, S., Adami, J., Stenros, C., Wredmark, T., & Felländer-Tsai, L. (2012). A population-based nationwide study of cruciate ligament injury in Sweden, 2001-2009: incidence, treatment, and sex differences. The American journal of sports medicine40(8), 1808-1813.
[4] Orchard, J. W., Engebretsen, L., & Feller, J. A. (2012). The rate of anterior cruciate ligament reconstruction in Australia is high: a national registry is needed. Scand J Med Sci Sports22, 495-501.