Outcome of patients with anterior cruciate ligament injuries selected for conservative treatment

In this retrospective study, 24 patients with acute isolated complete anterior cruciate ligament (ACL) ruptures selected for conservative treatment were re-examined a median of 45 months after injury. Selection for conservative treatment was made after careful patient information, taking into consideration desire for physical activity at work or leisure, interest in sports and muscular fitness. The reference group for the evaluation methods used included 50 students and 22 patients selected for surgical augmentation and reconstruction. In a subjective evaluation, the conservatively treated patients were satisfied, but objectively they had low functional scores and the pivot shift sign was often positive. Arthrometry showed that these patients had an increased anterior displacement of the tibia in relation to the femur in their injured knees. The patients who had a clearly positive pivot shift sign (grades III and IV) had an increased anterior laxity not only in the injured knees but also in the uninjured knees.