Filbay et al, 2019 ACL and Meniscus tear Systematic Review

Written By Bevan Colless

The Fibay et al (2019) is an excellent paper with a good overall synthesis of the literature with recommendations after an ACL injury. Key findings are:

  • Mis-diagnosis in emergency departments is common. Usually diagnosed as a general knee sprain

  • Special Tests by competent clinicians are essential. The Lachman’s test has similar accuracy to MRI

  • Psychological barriers to return to sport are common and significant

  • Most studies included in these reviews do not reflect best practice for nonoperative management of ACL rupture, despite this studies comparing non-operative and reconstructed groups show similar outcomes in ACL-deficient and ACL-reconstructed groups

  • Patients should undergo a minimum of 9 months of rehabilitation before returning to sports involving cutting

  • Risk of early onset osteoporosis-arthritis is elevated equally in operative and non-operative groups.

In summary the authors suggest carefully consideration of many factors before deciding to undergo a ACL reconstruction

Bevan Colless
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Japanese Study: Bracing Protocol produces 80% Healing Rate in ACLs.
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Case Report on an English Premier League Player with return to play in less than 8 weeks post ACL rupture