Lund University logoOften young athletes undergo anterior cruciate ligament (ACL) injuries of the knee. Patients with such an injury may be subjected to surgical reconstruction. A team of scientists from the Lund University claims that 60 per cent of these operations can be prevented even without negatively affecting results of the treatment.

The investigation called as the KANON study was embarked in 2001 on a total of 121 patients. All study subjects aged between 18 and 35, suffered from an acute ACL injury in a previously healthy knee. All volunteers who were either professional athletes or those who didn’t practice their respective sport regularly were not included in the investigations. Qualified physiotherapists carried out extensive rehabilitation on all the participants.

Richard Frobell, studyer at Lund University, Skåne University Hospital and Helsingborg Hospital quoted, “In our study, patients with acute ACL injuries were randomly divided into two groups for treatment with rehabilitation plus early ACL reconstruction or rehabilitation alone with the possibility of a later operation if this was deemed necessary. After two years only 40 per cent of the latter group needed to have an ACL reconstruction. Despite the fact that many of the patients were active sportsmen and women, we found no difference between the treatment groups in terms of knee function, activity level or well-being two years after the injury. Neither did we find any difference in these respects when we compared those who were treated with rehabilitation alone with those who had an early operation.”

The experts randomly selected sixty-two patients to go through surgical reconstruction of the injured ligament within four to six weeks of the injury. On the other hand, 59 patients were provided with only rehabilitation. It was assured that advanced methods and professional surgeons were employed throughout the study. Over a period of two years, all the patients were under observation and were allowed to provide their own opinions of the injured knee.

Stefan Lohmander, professor and consultant at Lund University and Skåne University Hospital affirmed, “There are almost 10 000 scientific publications addressing the ACL and 50 per cent of these are about surgical treatment. However, none of these studies have shown that surgical reconstruction produces better results than rehabilitation alone. Despite this, we perform 3 000 cruciate ligament reconstructions a year in Sweden. In the USA there are 200 000 operations of this type, at a cost of USD 3 billion!”

Astonishingly patients belonging to both the groups revealed similar results, with only four out of ten displaying a requirement on undergoing an operation. All the patients are still under inspection for determining the long term effects and differences in both the treatment methods. Also risk of developing osteoarthritis in the knee will be monitored in these patients.

The study is published on 22 July 2010 in the scientific journal the New England Journal of Medicine.