It is commonly believed that early ACL reconstruction can help prevent future meniscus injuries as a stable knee is obviously better than an unstable knee.

However, the studies to date do not support that assumption (Filbay et al 2019)

For instance, this prospective study found that early ACL reconstruction surgery was not superior to early intensive rehab alone with respect to return to function, symptoms or risk of re-injuries within 2 years.

Another multicentre 2021 RCT showed that “…50% of the patients randomised to the rehabilitation group did not need surgical reconstruction.” –Reijman et al 2021

The truth is that some patients with ongoing sense of instability will benefit from surgery while others will recover without surgery, but just need aggressive rehab.

Regrettably to date, there is a lack of evidence as to who is exactly most likely to benefit from ACL surgery.

“Sex and knee joint laxity tests do not predict the need for ACL reconstruction…” – Eggerding et al 2015

What the studies are saying is that it is no longer justified to make a blanket statement that all athletes who tear their ACL should automatically and immediately get surgery, some need it, some don’t why not try rehabbing first and seeing what happens?

REFERENCE: Filbay SR. Early ACL reconstruction is required to prevent additional knee injury: a misconception not supported by high-quality evidence. Br J Sports Med. 2019 Apr;53(8):459-461.
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