Description
Background:
Today, both operative and non-operative treatment of Anterior Cruciate Ligament (ACL) injuries are considered viable treatment options depending on the individual patient's preference. The Danish Knee Ligament Reconstruction Registry (DKRR) monitor the outcomes of surgeries for ACL-injury. However, there is no registry for ACL injury patients who are managed non-operatively.
Aim:
To investigate how many patients remained non-operatively treated five years after physiotherapy-led non-operative treatment.
Furthermore, we aimed to describe and compare the demographics and epidemiology characteristics of patients who managed with non-operative treatment and patients who failed non-operative treatment and underwent an ACLR.
Methods:
A retrospective analysis was performed to identify patients with ACL injuries referred to non-operative treatment at The Orthopaedic Rehabilitation Center in Aarhus between 2014 and 2018. Demographic and epidemiology data were extracted from medical records. Furthermore, patients were encouraged to complete a questionnaire. Finally, data from the Danish Knee Ligament Registry was extracted to identify the patients who underwent ACLR.
Results:
A total of 289 patients (290 knees), 63.5% (184 females) with a mean age at initiation of rehab of 37.4 years (range 18-64) were identified in medical records.
74 % (216 patients) managed with non-operative treatment five years after physiotherapy-led non-operative treatment. 76 % (140 patients) of these were females, mean age was 39.2 years and 161 patients had an isolated ACL injury while 52 had ACL and medial collateral ligament (MCL) injury.
Of the 72 patients than converted to ACL reconstruction were 66 % females and had a mean age was 32.7 years. 48 patients had an isolated ACLR, three patients had ACL and MCL reconstruction while 21 patients had ACL and meniscal surgery. Mean time from physiotherapy-led non-operative treatment to ACLR was nine months.
Conclusions:
74 % of patients with ACL injury treated non-operatively manage without ACLR five years after treatment. Women were higher represented (64 %) among patients referred to non-operative treatment. Patients converted to ACLR within the first year after treatment.
