Exploring the efficacy of conservative management versus surgical intervention in anterior cruciate ligament (ACL) injuries : insights into reinjury rates, quality of life, and long-term outcomes
Onobun, Daniel E. Orji, Chijioke Ojo, Ethel O. Adebisi, Ajibola A. Igbokwe, Kenechukwu Sehmar, Rajinder Ononye, Reginald Aksaray, Olgun Oputa, Stephen Nmereole, Chidera S.
Onobun, Daniel E.
Orji, Chijioke
Ojo, Ethel O.
Adebisi, Ajibola A.
Igbokwe, Kenechukwu
Sehmar, Rajinder
Ononye, Reginald
Aksaray, Olgun
Oputa, Stephen
Nmereole, Chidera S.
Affiliation
South Warwickshire University NHS Foundation Trust; Liverpool University Hospitals NHS Foundation Trust; Epsom and St. Helier University NHS Foundation Trust; Gateshead Health NHS Foundation Trust; Stockport NHS Foundation Trust; Altnagelvin Area Hospital, Londonderry; University of Benin, Nigeria; Kaplan Business School, Sydney, Australia
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Publication date
2024-11-29
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Abstract
This systematic review and meta-analysis evaluate the comparative outcomes of conservative management versus surgical intervention for anterior cruciate ligament (ACL) injuries. A comprehensive search of PubMed, Cochrane Library, Web of Science, SPORTDiscus, and Google Scholar focused on studies published between 2010 and 2024. Data synthesis employed both thematic analysis for qualitative data and meta-analysis for quantitative outcomes. Key findings indicate that conservative management yields lower reinjury rates and higher quality of life (QoL) scores (64.6 vs. 57.1) compared to surgical intervention, though differences were not statistically significant (p = 0.1483). Both strategies demonstrated comparable return-to-sport (RTS) rates. Meta-regression analysis revealed that longer follow-up durations positively influenced outcomes (p = 0.0288). The average complication rate was 49.83 per study (CI: 25.84-73.82), underscoring significant risks associated with both approaches. Conservative management shows promise as an initial treatment option for certain ACL injuries, particularly regarding reinjury prevention and QoL improvements. However, surgical intervention remains crucial for specific cases requiring enhanced knee stability. The results underscore the importance of individualized treatment planning, long-term follow-up, and further standardization of outcome measures in future research.
Keywords: acl injuries; conservative management; long-term outcomes; meta-analysis; quality of life; reinjury rates; return-to-sport; surgical intervention.
Citation
Onobun DE, Orji C, Ojo EO, Adebisi AA, Igbokwe K, Sehmar R, Ononye R, Aksaray O, Oputa S, Nmereole CS. Exploring the Efficacy of Conservative Management Versus Surgical Intervention in Anterior Cruciate Ligament (ACL) Injuries: Insights Into Reinjury Rates, Quality of Life, and Long-Term Outcomes. Cureus. 2024 Nov 29;16(11):e74718. doi: 10.7759/cureus.74718.
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Article