A 10-Year Prospective Trial of a Patient Management Algorithm and Screening Examination for Highly Active Individuals with Anterior Cruciate Ligament Injury
- 16 October 2007
- journal article
- clinical trial
- Published by SAGE Publications in The American Journal of Sports Medicine
- Vol. 36 (1), 40-47
- https://doi.org/10.1177/0363546507308190
Abstract
Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture. Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care. Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care. Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up. Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.Keywords
This publication has 40 references indexed in Scilit:
- Classification of functional recovery of anterior cruciate ligament copers, non-copers, and adaptersBritish Journal of Sports Medicine, 2006
- Surgical versus conservative interventions for anterior cruciate ligament ruptures in adultsPublished by Wiley ,2005
- High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injuryArthritis & Rheumatism, 2004
- 1998 Basmajian Student Award Paper: Movement patterns after anterior cruciate ligament injury: a comparison of patients who compensate well for the injury and those who require operative stabilizationJournal of Electromyography and Kinesiology, 1998
- Early Season Anterior Cruciate Ligament TearsThe American Journal of Sports Medicine, 1997
- Nonoperative Treatment of Acute Anterior Cruciate Ligament Injuries in a Selected Group of PatientsThe American Journal of Sports Medicine, 1995
- Knee Laxity and Function After Conservative Treatment of Anterior Cruciate Ligament InjuriesInternational Journal of Sports Medicine, 1993
- Knee Function After Surgical or Nonsurgical Treatment of Acute Rupture of the Anterior Cruciate LigamentClinical Orthopaedics and Related Research, 1991
- The Outcome of Nonoperatively Treated Complete Tears of the Anterior Cruciate Ligament in Active Young AdultsClinical Orthopaedics and Related Research, 1990
- Followup of the acute nonoperated isolated anterior cruciate ligament tearThe American Journal of Sports Medicine, 1986