Surgery vs. Conservative Care for ACL Injuries

ACL-injury-surgery-rehabilitation-physical therapy

In our prior posts on ACL injuries we have discussed the support in the medical literature for the conservative management of these tears using Physical Therapy alone.  The evidence supports the conservative management of segment of the injured population who are able to "cope" with their ACL tear and still function at a high level of activity.   These individuals demonstrate high levels of strength, balance, and agility after completing their Physical Therapy program.  

Recently a Cochrane Review was completed on the available evidence comparing the surgical versus conservative management of ACL injuries.  The authors concluded there was limited evidence showing no difference between surgery and Physical Therapy for acute ACL tears at either 2 or 5 year follow up.  Importantly, the research shows many individuals opting for early Physical Therapy remained symptomatic and opted for a later ACL reconstruction.  This study adds to the available evidence showing some individuals can return to high level activity after an ACL tear using Physical Therapy alone.  Others after completing a program of Physical Therapy may opt for the surgery due to remaining symptoms.