Conservative Management of Isolated ACL Tears Compares Favorably with Early Surgical Repair

In a Swedish trial in which conservative management was compared with early surgical repair of isolated anterior cruciate ligament (ACL) tears, early outcomes were similar (NEJM JW Gen Med Sep 1 2010 and N Engl J Med 2010; 363:331; NEJM JW Gen Med Mar 1 2013 and BMJ 2013; 346:232). The investigators now report 11-year functional outcomes and risk for developing osteoarthritis in both groups. Originally, 121 young adults (mean age, 26; mostly men) who were actively involved in sports were randomized to early surgical repair or to intense exercise rehabilitation with the option for delayed surgical repair. Slightly more than half of patients who were randomized to conservative management eventually chose surgical repair.

Anatomic stability ass…