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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-08-2020 | KNEE

Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group

Authors: Theresa Diermeier, Benjamin B. Rothrauff, Lars Engebretsen, Andrew D. Lynch, Olufemi R. Ayeni, Mark V. Paterno, John W. Xerogeanes, Freddie H. Fu, Jon Karlsson, Volker Musahl, Eleonor Svantesson, Eric Hamrin Senorski, Thomas Rauer, Sean J. Meredith, The Panther Symposium ACL Treatment Consensus Group

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2020

Abstract

Treatment strategies for anterior cruciate ligament (ACL) injuries continue to evolve. Evidence supporting best practice guidelines for the management of ACL injury is to a large extent based on studies with low-level evidence. An international consensus group of experts was convened to collaboratively advance toward consensus opinions regarding the best available evidence on operative vs. non-operative treatment for ACL injury. The purpose of this study is to report the consensus statements on operative vs. non-operative treatment of ACL injuries developed at the ACL Consensus Meeting Panther Symposium 2019. Sixty-six international experts on the management of ACL injuries, representing 18 countries, were convened and participated in a process based on the Delphi method of achieving consensus. Proposed consensus statements were drafted by the Scientific Organizing Committee and Session Chairs for the three working groups. Panel participants reviewed preliminary statements prior to the meeting and provided the initial agreement and comments on the statement via an online survey. During the meeting, discussion and debate occurred for each statement, after which a final vote was then held. Eighty percent agreement was defined a-priori as consensus. A total of 11 of 13 statements on operative v. non-operative treatment of ACL injury reached the consensus during the Symposium. Nine statements achieved unanimous support, two reached strong consensus, one did not achieve consensus, and one was removed due to redundancy in the information provided. In highly active patients engaged in jumping, cutting, and pivoting sports, early anatomic ACL reconstruction is recommended due to the high risk of secondary meniscus and cartilage injuries with delayed surgery, although a period of progressive rehabilitation to resolve impairments and improve neuromuscular function is recommended. For patients who seek to return to straight plane activities, non-operative treatment with structured, progressive rehabilitation is an acceptable treatment option. However, with persistent functional instability, or when episodes of giving way occur, anatomic ACL reconstruction is indicated. The consensus statements derived from international leaders in the field will assist clinicians in deciding between operative and non-operative treatments with patients after an ACL injury.

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Title: Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group
Authors: Theresa Diermeier
Benjamin B. Rothrauff
Lars Engebretsen
Andrew D. Lynch
Olufemi R. Ayeni
Mark V. Paterno
John W. Xerogeanes
Freddie H. Fu
Jon Karlsson
Volker Musahl
Eleonor Svantesson
Eric Hamrin Senorski
Thomas Rauer
Sean J. Meredith
The Panther Symposium ACL Treatment Consensus Group
Publication date: 01-08-2020
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2020
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-020-06012-6

At a glance: The STEP trials

Springer Medicine

Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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