{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T04:53:54Z","timestamp":1788324834021,"version":"build-2803163510"},"reference-count":5,"publisher":"National Athletic Trainers' Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>Reference\/Citation:<\/jats:title>\n                  <jats:p>Frobell RB, Roos HP, Roos EM, Roemer FW, Ranstam J, Lohmander LS. Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial. BMJ. 2013;346:F232.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Question:<\/jats:title>\n                  <jats:p>Does early anterior cruciate ligament (ACL) reconstruction with rehabilitation lead to better patient-reported outcomes and a lower incidence of osteoarthritis at 5 years postinjury compared with delayed ACL reconstruction with rehabilitation?<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study Selection:<\/jats:title>\n                  <jats:p>This randomized controlled trial with extended follow-up at 5 years postrandomization was conducted in 2 Swedish orthopaedic departments.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data Extraction:<\/jats:title>\n                  <jats:p>The authors studied a total of 121 moderately active adults (age = 18\u201335 years) with an acute ACL rupture in a knee with no other history of trauma. Excluded were patients with a collateral ligament rupture, full-thickness cartilage defect, or extensive meniscal fixation. One patient assigned to the early ACL-reconstruction group did not attend the 5-year follow-up visit. Patients were randomly assigned to (1) an early ACL reconstruction plus structured rehabilitation group (n = 62, surgery within 10 weeks of injury) or (2) optional-delayed ACL reconstruction plus structured rehabilitation group (n = 59). The primary outcome measure was change in the average of 4 out of 5 subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS). The authors also assessed crude KOOS (combined 4 subscales), KOOS subscale scores, general physical and mental health (Short-Form 36), activity level (Tegner Activity Scale), mechanical knee stability (Lachman and pivot shift tests), meniscal surgery status, and presence of knee osteoarthritis on radiographs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Results:<\/jats:title>\n                  <jats:p>Among patients randomized to the optional-delayed ACL-reconstruction group, 30 (51%) opted for an ACL reconstruction. The treatment groups had comparable 5-year patient-reported outcomes and changes in patient-reported outcomes (eg, knee pain, knee symptoms, activities of daily living, sport and recreational levels, knee-related quality of life, general physical health, and general mental health). Patients in the optional-delayed ACL-reconstruction group had greater mechanical knee instability than patients who received early ACL reconstruction; however, this was primarily among the patients opting for conservative management alone. In the overall sample, 61 knees (51%) required meniscal surgery over 5 years, regardless of treatment group. At 5 years, radiographs were available for 113 patients (93%). Overall, 29 patients (26%) had knee osteoarthritis at 5 years. Specifically, 13 patients (12%) developed tibiofemoral radiographic osteoarthritis (9 patients [16%] in the early ACL-reconstruction group, 4 [7%] in the optional-delayed ACL-reconstruction group) and 22 (19%) developed patellofemoral osteoarthritis (14 patients [24%] in the early ACL-reconstruction group, 8 [15%] in the optional-delayed ACL-reconstruction group). Patients with patellar tendon grafts (n = 40) had a greater incidence of ipsilateral patellofemoral osteoarthritis than patients with hamstrings tendon grafts (n = 51), but the 2 groups had similar incidences of ipsilateral tibiofemoral osteoarthritis. Six knees (5%) had both tibiofemoral and patellofemoral osteoarthritis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>Early ACL reconstruction plus rehabilitation did not provide better results at 5 years compared with optional-delayed ACL reconstruction plus rehabilitation. Furthermore, the authors found no radiographic differences among patients with early ACL reconstruction, delayed ACL reconstruction, or no ACL reconstruction (rehabilitation alone).<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-49.3.53","type":"journal-article","created":{"date-parts":[[2014,10,16]],"date-time":"2014-10-16T14:04:01Z","timestamp":1413468241000},"page":"110-112","source":"Crossref","is-referenced-by-count":23,"title":["Five-Year Clinical Outcomes of a Randomized Trial of Anterior Cruciate Ligament Treatment Strategies: An Evidence-Based Practice Paper"],"prefix":"10.4085","volume":"50","author":[{"given":"Kyle","family":"Harris","sequence":"first","affiliation":[{"name":"Department of Health, Physical Education and Nursing, Bucks County Community College, Newtown, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey Bradford","family":"Driban","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Tufts Medical Center, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Sitler","sequence":"first","affiliation":[{"name":"Biokinetics Research Laboratory, Athletic Training Division, Department of Kinesiology, Temple University, Philadelphia, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M.","family":"Cattano","sequence":"first","affiliation":[{"name":"Department of Sports Medicine, West Chester University, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Hootman","sequence":"first","affiliation":[{"name":"Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"key":"2020060411195961400_i1062-6050-50-1-110-b01","article-title":"Influence of anterior cruciate ligament injuries with and without surgical reconstruction on the development of osteoarthritis of the knee: a systematic review","author":"Harris","journal-title":"J Athl Train"},{"key":"2020060411195961400_i1062-6050-50-1-110-b02","doi-asserted-by":"crossref","first-page":"F232","DOI":"10.1136\/bmj.f232","article-title":"Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial","volume":"346","author":"Frobell","year":"2013","journal-title":"BMJ"},{"issue":"4","key":"2020060411195961400_i1062-6050-50-1-110-b03","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1056\/NEJMoa0907797","article-title":"A randomized trial of treatment for acute anterior cruciate ligament tears","volume":"363","author":"Frobell","year":"2010","journal-title":"N Engl J Med"},{"issue":"2","key":"2020060411195961400_i1062-6050-50-1-110-b04","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1177\/036354659702500209","article-title":"The relationship between passive joint laxity and functional outcome after anterior cruciate ligament injury","volume":"25","author":"Snyder-Mackler","year":"1997","journal-title":"Am J Sports Med"},{"issue":"12","key":"2020060411195961400_i1062-6050-50-1-110-b05","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.2106\/JBJS.J.00929","article-title":"Change in cartilage thickness, posttraumatic bone marrow lesions, and joint fluid volumes after acute ACL disruption: a two-year prospective MRI study of sixty-one subjects","volume":"93","author":"Frobell","year":"2011","journal-title":"J Bone Joint Surg Am"}],"container-title":["Journal of Athletic Training"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/50\/1\/110\/2276395\/1062-6050-49_3_53.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/50\/1\/110\/2276395\/1062-6050-49_3_53.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T18:53:03Z","timestamp":1749667983000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/50\/1\/article-p110.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,1]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1,1]]}},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-49.3.53","relation":{},"ISSN":["1062-6050"],"issn-type":[{"value":"1062-6050","type":"print"}],"subject":[],"published":{"date-parts":[[2015,1,1]]}}}