Ten year follow-up study comparing conservative versus operative treatment of anterior cruciate ligament ruptures. A matched-pair analysis of high level athletes

Meuffels, Duncan E.; Favejee, Marein M.; Vissers, M.M.; Heijboer, M.P.; Reijman, Max; Verhaar, Jan A N

doi:10.1136/bjsm.2008.049403

Cited by 179 publications

(195 citation statements)

References 35 publications

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“…Similarly, a prospective cohort study by Moknes et al found no difference in performance-based outcomes and the number of subjects returning to pre-injury activity levels between non-operatively and operatively treated groups 67 . In a case-control study Meuffels et al also found no statistical difference in activity levels or subjective and objective functional outcomes at 10 years post-injury between patients treated conservatively or operatively 68 .…”

Section: Surgical Vs Non-surgical Treatmentmentioning

confidence: 99%

The Health and Structural Consequences of Acute Knee Injuries Involving Rupture of the Anterior Cruciate Ligament

Riordan

Frobell

Roemer

et al. 2013

Rheumatic Disease Clinics of North America

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Word Count: 4183 2 3 SynopsisAlthough there is an abundance of literature regarding the development of knee osteoarthritis following rupture of the anterior cruciate ligament (ACL), the exact mechanism underlying this link is still not clear.Recent studies have reported that a number of factors may be predictive of the subsequent development of osteoarthritis, with damage to the menisci and articular cartilage during the initial trauma, altered knee biomechanics post-injury, and episodic instability chief among them. This article summarizes recent developments in the understanding of the joint damage resulting from an ACL tear, and the influence that current and future treatment methods may have on the long-term progression to osteoarthritis.

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Section: Surgical Vs Non-surgical Treatmentmentioning

confidence: 99%

The Health and Structural Consequences of Acute Knee Injuries Involving Rupture of the Anterior Cruciate Ligament

Riordan

Frobell

Roemer

et al. 2013

Rheumatic Disease Clinics of North America

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“…The rate of osteoarthritis changes is higher in patients with reconstructed ACLs compared with patients with chronic ACL deficiency who had not undergone ACL reconstruction. Meuffels et al 19 compared 25 patients with ACL deficiency who received only conservative management for 10 years with a matched group of patients who received bone-patella tendon-bone ACL reconstruction 10 years previously and found more radiographic evidence of osteoarthritis changes in the surgical group (28% vs 48%, respectively), although the operated knees were more stable.…”

Section: Prevention Of Osteoarthritismentioning

confidence: 99%

ACL Stability, Function, and Arthritis: What Have We Been Missing?

Maffulli¹,

Osti²

2013

Orthopedics

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Section: Current Treatment For Acl Injuriesmentioning

confidence: 99%

“…Since ACL injuries contribute to an increased risk of knee osteoarthritis [14,15], the current gold standard for the management of complete ACL rupture is reconstruction using a tendon autograft. However, there are no highquality randomized controlled trials comparing ACL reconstruction with other modalities of treatment [16][17][18][19].However, it is clear that the spontaneous healing capacity of the ACL has been underestimated. Several clinical studies have reported results of ACL healing with non-surgical treatment alone [20][21][22].…”

mentioning

confidence: 99%

Key Determinants of Anterior Cruciate Ligament Spontaneous Healing

Kokubun¹,

Kanemura²,

Murata³

et al. 2017

J Osteopor Phys Act

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Anterior cruciate ligament (ACL) injuries are known to have very low rates of spontaneous healing. There have been several studies since the mid-1960s concerning the approaches to accelerate spontaneous healing of ACL injuries. Recent studies have identified similarities in the healing response of ACL and other extra-articular ligaments, in terms of their cellular response and vascularity. Research has demonstrated that mechanical stress has an important influence on the biological response of tissue healing. Novel treatment approaches may exploit the role of mechanical loads on the regulation of gene expression in achieving spontaneous healing of injured ACL. This article reviews the determinants of the ACL healing response and their relationship to mechanical stress and spontaneous healing, and explores novel concepts that are emerging in the management of ACL injuries. Keywords Current Treatment for ACL injuriesThe anterior cruciate ligament (ACL) plays an important role in motion at the knee joint and therefore, in the related physical activities of daily living. The ACL stabilizes the knee and guides the movement of the tibia and femur at the joint. Injuries involving the ACL are well known for hopeless of spontaneous healing. Several studies have investigated the mechanisms of low healing response and the approaches to accelerating spontaneous healing of ACL injuries, since the mid-1960s [1][2][3][4]. The reasons for the failure of the ACL to heal spontaneously are related to specific intra-articular features [5,6] as well as owing to various molecular biological characteristics [7,8]. A number of studies have addressed on explaining the reasons for the failure of the ACL to heal spontaneously [1,3,[9][10][11][12][13]. Since ACL injuries contribute to an increased risk of knee osteoarthritis [14,15], the current gold standard for the management of complete ACL rupture is reconstruction using a tendon autograft. However, there are no highquality randomized controlled trials comparing ACL reconstruction with other modalities of treatment [16][17][18][19].However, it is clear that the spontaneous healing capacity of the ACL has been underestimated. Several clinical studies have reported results of ACL healing with non-surgical treatment alone [20][21][22]. Moreover, an organ culture model of the human ACL showed a high intrinsic healing capacity [23]. Although these studies have demonstrated that the human ACL remnant has functional healing capacities, this was not proved in rigorous scientific methods. Consequently, current non-surgical treatment for ACL injuries aims at rehabilitating patients to modify the patients' physical activities to continue their dairy living, but not to support their spontaneous healing of the injured ACL [24,25]. This comprises muscle strength exercises, range of motion exercises, neuro-muscular training, and bracing. To summarize, although surgical reconstruction with autograft is considered to be the standard of care for restoring knee function following complete ACL in...

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Ten year follow-up study comparing conservative versus operative treatment of anterior cruciate ligament ruptures. A matched-pair analysis of high level athletes

Abstract: We conclude that the instability repair using a bone-patella-tendon-bone anterior cruciate ligament reconstruction is a good knee stabilising operation. Both treatment options however show similar patient outcome at 10 year follow up.

Cited by 179 publications

References 35 publications

The Health and Structural Consequences of Acute Knee Injuries Involving Rupture of the Anterior Cruciate Ligament

The Health and Structural Consequences of Acute Knee Injuries Involving Rupture of the Anterior Cruciate Ligament

ACL Stability, Function, and Arthritis: What Have We Been Missing?

Key Determinants of Anterior Cruciate Ligament Spontaneous Healing

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