NONOPERATIVE TREATMENT OF ACUTE ANTERIOR CRUCIATE LIGAMENT INJURIES IN A SELECTED GROUP OF PATIENTS

Conservative treatment of acute anterior cruciate ligament injuries wa s recommended to selected patients, including those with sedentary occ upations, low athletic demands, or ages greater than 30 years. Patient s with generalized hyperligamentous laxity were excluded. Fifty-five o f 61 patients were available at an average followup of 46 months from the time of initial injury. At followup, giving-way symptoms had not o ccurred in 23 patients (42%); in 22 (40%) giving way occurred occasion ally. Of the 44 patients involved in high- or moderate-demand athletic s, 33 (70%) were able to continue with moderate-demand sports. Presenc e of a medial collateral ligament sprain did not affect the longterm f unction. Forty-eight percent of the patients scored excellent or good (9 and 18 patients, respectively) on the Hospital for Special Surgery ligament scoring system; 8 (15%) later chose surgical reconstruction. The remaining 47 patients did not believe that their symptoms were sev ere enough to warrant any further intervention. In a group of individu als who are older and relatively inactive, nonoperative management of anterior cruciate ligament injuries can yield satisfactory results, pr ovided the patients are willing to accept a modest amount of instabili ty and a slight risk of meniscal injury.