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Controversies in the Technical Aspects of ACL Reconstruction pp 491–498Cite as

Nonoperative Management of ACL Rupture

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Abstract

Anterior cruciate ligament (ACL) reconstruction is common after ACL injury, particularly in young, active individuals. ACL reconstruction does not have universally good outcomes. Not all athletes will return to sport after ACL reconstruction (ACLR), and after reconstruction these individuals are at a high risk for second ACL injury and osteoarthritis. The best evidence suggests that ACLR is not necessary for everyone. This chapter will discuss the management of athletes after acute ACL rupture. Long- and short-term outcomes of operative and nonoperative management as well as determinants of success will be discussed. Athletes can return to their prior levels of sports without ACL reconstruction with progressive rehabilitation after ACL rupture. With recent evidence that outcomes after operative and nonoperative ACL injury management do not necessarily favor surgery, the authors recommend that athletes undergo a progressive physical therapy regimen that includes strengthening and neuromuscular training after ACL injury prior to the decision to undergo ACLR. If nonoperative management is elected as progressive, a criterion-based rehabilitation program culminating in a structured return to activity progression and battery of tests to determine readiness for return to sports should be employed.

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Authors and Affiliations

  1. Department of Physical Therapy and Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, DE, USA

    Lynn Snyder-Mackler, Amelia Arundale, Mathew Failla & Elizabeth Wellsandt

  2. Musculoskeletal and Sport Medicine Clinic, NIMI and the Norwegian Research Center for Active Rehabilitation, Oslo, Norway

    Hege Grindem & May Arna Risberg

  3. The Isokinetic Medical Group, Bologna, Italy

    Margherita Ricci & Stefano Della Villa

Authors
  1. Lynn Snyder-Mackler
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  2. Amelia Arundale
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  3. Mathew Failla
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  4. Elizabeth Wellsandt
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  5. Hege Grindem
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  6. Margherita Ricci
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  7. Stefano Della Villa
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  8. May Arna Risberg
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Corresponding author

Correspondence to Lynn Snyder-Mackler .

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Editors and Affiliations

  1. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan

    Norimasa Nakamura

  2. Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy

    Stefano Zaffagnini

  3. Hospital for Special Surgery, New York, New York, USA

    Robert G. Marx

  4. UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania, USA

    Volker Musahl

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Snyder-Mackler, L. et al. (2017). Nonoperative Management of ACL Rupture. In: Nakamura, N., Zaffagnini, S., Marx, R., Musahl, V. (eds) Controversies in the Technical Aspects of ACL Reconstruction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-52742-9_45

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  • DOI: https://doi.org/10.1007/978-3-662-52742-9_45

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