Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2008 Jan;36(1):40-7.
doi: 10.1177/0363546507308190. Epub 2007 Oct 16.

A 10-year prospective trial of a patient management algorithm and screening examination for highly active individuals with anterior cruciate ligament injury: Part 1, outcomes

Wendy J Hurd  1 , Michael J Axe, Lynn Snyder-Mackler
Affiliations
Clinical Trial

A 10-year prospective trial of a patient management algorithm and screening examination for highly active individuals with anterior cruciate ligament injury: Part 1, outcomes

Wendy J Hurd et al. Am J Sports Med. 2008 Jan.

Abstract

Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Treatment and Screening Examination Algorithm Outcomes
PC=Potential Coper; NC=Non-Coper; ACLR=ACL Reconstruction; Rehab=Rehabilitation; RTS=Return To Sports
See this image and copyright information in PMC

References

    1. Alkjaer T, Simonsen EB, Jorgensen U, Dyhre-Poulsen P. Evaluation of the walking pattern in two types of patients with anterior cruciate ligament deficiency: copers and non-copers. Eur J Appl Physiol. 2003;89:301–308. - PubMed
    1. Alkjaer T, Simonsen EB, Peter Magnusson SP, Aagaard H, Dyhre-Poulsen P. Differences in the movement pattern of a forward lunge in two types of anterior cruciate ligament deficient patients: copers and non-copers. Clin Biomech (Bristol, Avon) 2002;17:586–593. - PubMed
    1. Andersson AC. Knee laxity and function after conservative treatment of anterior cruciate ligament injuries. A prospective study. Int J Sports Med. 1993;14:150–153. - PubMed
    1. Andersson AC. Knee laxity and function after conservative treatment of anterior cruciate ligament injuries. A prospective study. Int J Sports Med. 1993;14:150–153. - PubMed
    1. Andersson C, Odensten M, Gillquist J. Knee function after surgical or nonsurgical treatment of acute rupture of the anterior cruciate ligament: a randomized study with a long-term follow-up period. Clin Orthop Relat Res. 1991:255–263. - PubMed

Publication types