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Physiotherapy Research Reviews — 12 Studies Reviewed Monthly

Key Points

There are four main characteristics on MRI that can help clinicians to hypothesize about the likelihood of achieving knee stability with conservative care following ACL tear.

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BACKGROUND AND OBJECTIVE

There are an estimated 400,000 ACL reconstructions worldwide per year, with this number continuing to grow (1). Prior to the 1990’s, most ACL ruptures went undiagnosed. Surgery was only considered in individuals with severe knee instability. The emergence of the MRI created a shift toward early diagnosis while improved surgical techniques and outcomes have made early intervention the standard of care for most athletes who are looking for an expedient return to sport.

Recent research has shown acute ACL ruptures have a greater capacity to heal than we previously understood by utilizing the cross-bracing protocol (2). Not everyone needs surgery to achieve knee stability following an ACL rupture, but we have yet to establish criteria to determine who are the best candidates for conservative care. The authors of this paper aim to propose a new way of grading acute ACL rupture that will help clinicians to assess features of the imaging study that are relevant to the ACL healing potential.

There are an estimated 400,000 ACL reconstructions worldwide per year, with this number continuing to grow.

It feels almost irresponsible for clinicians to not educate patients on the potential efficacy of non-surgical management for their ACL injury.

METHODS

This paper is a viewpoint written by authors who have managed 1080 patients while studying the cross-bracing protocol and ACL conservative care.

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A new way of grading severity of ACL rupture on acute MRI to consider potential for non-surgical healing with the Cross Bracing Protocol: ACL acute rupture characteristics for healing (ACL-ARCH) MRI criteria

Key Points

BACKGROUND AND OBJECTIVE

METHODS