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Study: Wait to treat ACL tears in skiers with reconstructive surgery
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Researchers from Hospital for Special Surgery have found in a recently published study that 25% of patients who tear their ACL while skiing will not need surgery to heal.
“Some patients who tear their ACL while skiing can get away without surgery. Their ligament heals by itself, they will have stable knees, and they will be able to do whatever they want, including skiing,” Robert G. Marx, MD, of the Sports Medicine and Shoulder Service at Hospital for Special Surgery, stated in a press release. “It is a huge deal to avoid surgery.”
Robert G. Marx
Marx and colleagues evaluated 63 recreational alpine skiers seen by Marx between 2003 and 2008 with a minimum 2-year follow-up. Twenty-nine patients who did not undergo ACL reconstruction were designated as having “low-grade ACL injuries” due to low-grade Lachmann scores of 0 or 1 and negative pivot shift tests. In this group, 17 patients still maintained these low scores at 6 weeks to 12 weeks after injury, and 10 patients who returned at minimum 2-year follow-up still had low-grade Lachmann scores and negative pivot shift tests.
“Patients who tear their ACL during recreational skiing should not rush to schedule surgery right after their injury,” Marx said. “They should wait and be reevaluated at 6 weeks to 12 weeks unless there is some other obvious reason to do surgery, like a displaced meniscal tear or other ligament injuries. Most recreational skiers don’t have those, and they may be able to avoid surgery if they wait and get reevaluated.”
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Reference:
Hetsroni I. Knee Surg Sports Traumatol Arthrosc. 2012; doi:10.1007/s00167-012-2324-8.
Disclosure: Marx is on the Editorial Board for Knee Surgery, Sports Traumatology, Arthroscopy.