Podcast from BMJ on ACL surgery and need for quality conservative management
13:00 If you are wondering whether to have surgery or not after ACL injury – go for conservative management first. “Nothing to lose”. “A stiff knee is a time bomb for osteoarthritis later on.”
13:45 Osteoarthritis. Patients who don’t get all their movement back have a high risk of osteoarthritis moving forward. Many surgeons overlook the loss of motion as a risk factor.
Interesting comment on how he would rather have a slightly lax managing knee than a stiff knee that will have bigger problems later on. It’s not fun rehabbing an ACL who had full motion prior to surgery and is now dealing with a range of motion loss, some psychological buyer’s remorse after “fixing” a functional knee. Each case requires decision making based on the physical exam and ability of the patient to cope with their injury as the indicator for surgery or conservative management.