A recent study in the British Medical Journal in January 2013 study compared early acute Anterior Cruciate Ligament (ACL) Reconstruction surgery followed by physical therapy and another group who had just Rehabilitation Only (RO) followed by an acute ACL injury with the option of having surgery during the term of the study. Both groups were followed for five years. The results of study were as follows:
- No difference in patients reported outcomes between groups at 5 years
- No difference in the degree of Osteoarthritis (OA) in both groups
- ACL Surgery group noted earlier stability that RO group
- Greater number of patients requiring Meniscal surgery in RO group
This study was not conducted on professional athletes or only moderately active individuals so the findings should to these two groups until more research is done. The specific ACL reconstructive surgeries included both patella tendon and hamstring grafts of single bundle type of reconstruction. In recent years the technique used to reconstruct the ACL surgery that did not completely replicate the original anatomy of the torn ACL. That being said the double bundle approach, being used by more progressive surgeons may improve the outcomes in regards to developing osteoarthritis and overall patient satisfaction.
At this time I would opt for rehabilitation with the option of surgery more for lack of stability and pain after a minimum of 4-6 months.