Abstract
Background: The decision on how to manage a patient with an acute ACL tear diagnosed at arthroscopy is still very subjective. Since 1995 all such patients in a single surgeon practice were managed either surgically or conservatively based on a modification of criteria described by Daniel. This essentially takes into consideration the presence of associated injuries and the activity level of the patient.
Purpose: This study was conducted to determine if these criteria used were effective in selecting our patients for surgery or conservative treatment.
Methods: We randomly selected 100 patients treated with at least 2 years follow up. The operatively and conservatively treated groups were compared based on the Tegner activity scale, the Lysholm-II1 score before and after treatment and the IKDC score after treatment. These scores were calculated using information from case notes, X Rays, patient questionnaires and outpatient clinic assessments.
Results: There were 42 patients treated conservatively and 58 treated by ACL reconstruction. The average age was 32 years for the operative group and 34 years for the conservative group.
We found no statistically significant difference between the Lysholm-11 scores and the IKDC scores between the two groups.
Conclusion: The criteria used to determine the management of our patients with acute ACL injuries is effective and as such we recommend its use.
The abstracts were prepared by Mr R. B. Smith. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
