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Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group
- Source :
- Knee Surgery, Sports Traumatology, Arthroscopy
- Publication Year :
- 2020
-
Abstract
- Treatment strategies for anterior cruciate ligament (ACL) injuries continue to evolve. Evidence supporting best practice guidelines for the management of ACL injury is to a large extent based on studies with low-level evidence. An international consensus group of experts was convened to collaboratively advance toward consensus opinions regarding the best available evidence on operative vs. non-operative treatment for ACL injury. The purpose of this study is to report the consensus statements on operative vs. non-operative treatment of ACL injuries developed at the ACL Consensus Meeting Panther Symposium 2019. Sixty-six international experts on the management of ACL injuries, representing 18 countries, were convened and participated in a process based on the Delphi method of achieving consensus. Proposed consensus statements were drafted by the Scientific Organizing Committee and Session Chairs for the three working groups. Panel participants reviewed preliminary statements prior to the meeting and provided the initial agreement and comments on the statement via an online survey. During the meeting, discussion and debate occurred for each statement, after which a final vote was then held. Eighty percent agreement was defined a-priori as consensus. A total of 11 of 13 statements on operative v. non-operative treatment of ACL injury reached the consensus during the Symposium. Nine statements achieved unanimous support, two reached strong consensus, one did not achieve consensus, and one was removed due to redundancy in the information provided. In highly active patients engaged in jumping, cutting, and pivoting sports, early anatomic ACL reconstruction is recommended due to the high risk of secondary meniscus and cartilage injuries with delayed surgery, although a period of progressive rehabilitation to resolve impairments and improve neuromuscular function is recommended. For patients who seek to return to straight plane activities, non-operative treatment with structured, progressive rehabilitation is an acceptable treatment option. However, with persistent functional instability, or when episodes of giving way occur, anatomic ACL reconstruction is indicated. The consensus statements derived from international leaders in the field will assist clinicians in deciding between operative and non-operative treatments with patients after an ACL injury.Level of evidence V.
- Subjects :
- medicine.medical_specialty
Consensus
Anterior cruciate ligament reconstruction
Anterior cruciate ligament
medicine.medical_treatment
Best practice
education
Delphi method
610 Medicine & health
03 medical and health sciences
0302 clinical medicine
2732 Orthopedics and Sports Medicine
medicine
Humans
Knee
Orthopedics and Sports Medicine
ACL injury
030222 orthopedics
Functional instability
Rehabilitation
Anterior Cruciate Ligament Reconstruction
business.industry
Anterior Cruciate Ligament Injuries
Treatment options
030229 sport sciences
musculoskeletal system
medicine.disease
2746 Surgery
ddc
ACL reconstruction
10021 Department of Trauma Surgery
medicine.anatomical_structure
Treatment Outcome
Orthopedic surgery
Athletic Injuries
Physical therapy
Surgery
business
Working group
Non-operative treatment
Sports
Subjects
Details
- ISSN :
- 14337347
- Volume :
- 28
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
- Accession number :
- edsair.doi.dedup.....22692c5c4ab2646bb04a36de428cf42f