Friday, August 27, 2010

ACL Injury - Surgery or No Surgery

An interesting article in The New York Times regarding a study published in The New England Journal of Medicine.

A summary from The New York Times:

Over two years, the injured knees were assessed using a comprehensive numerical score that rated pain, function during activity and other measures. At the time of the original injury, the knee also had been scored. At the end of the two years, both groups showed considerable improvement. The scores for the surgically repaired knees had risen by 39.2 points. The scores for the more conservatively treated knees also had risen, by 39.4 points. In other words, the outcomes were virtually identical. Despite a widespread belief that surgery leads to a stronger knee, the results showed that surgically reconstructing the A.C.L. as soon as possible after the tear “was not superior” to more conservative treatment, the study’s authors wrote. The findings suggest, the authors concluded, that “more than half the A.C.L. reconstructions” currently being conducted on injured knees “could be avoided without adversely affecting outcomes.

....By one estimate, as many as 1 in every 556 fit, active people will tear an A.C.L. — particularly if they participate in sports that involve frequent pivoting and landing, like soccer, football, tennis, skiing and basketball. ”

I chose to have ACL surgery in 2007. I don't think I would have been able to continue karate training without a stable knee. I was also in a hurry to have my knee "fixed". However, I do worry about the long term health of my knee. Early onset arthritis is a common occurrence in a knee with an ACL reconstruction.


Kicker said...

Interesting...hard part is waiting the longer time period and then possibly finding out that it's not stable enough. My doctor found that my ACL had started to reattach itself to another part of my bone. He said that had I not had surgery it may have become stable enough over time. Something to think about should I have problems again down the road. Thanks for sharing the info.

BobSpar said...

Wow, really interesting study Michele, thanks for pointing it out. Confounding. I'm not going to regret getting ACL surgery, but I think I will point this article out to friends who are considering it.

Mathieu said...

I chose not to have it...

And everyday, I wonder what my knee would be like today if I did. :)

It does get better with time, but it feels like I have a spaghetti knee. I can run, but every 80 steps, there is something happening in my knee that isn't comfortable. It just goes sideways!


Be well

Michele said...

Thanks for visiting and commenting on my blog!

Kicker: I agree...the wait would be awful.

Mathieu: Sideways! :(
I hope you knee feels better.

TM said...

I think surgery is the way to go. Otherwise, you're limiting yourself in sports and activities the rest of your life. If you are active and injure it further, you're even worse off. Better to have the surgery and do it right the first time I think. I had mine in 2008 and am glad I did. See my blog to take a quick ACL surgery survey and see the results: