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Study identifies skiers who can be successfully treated without surgery after an ACL tear
Date:2/6/2013

on, the researchers combed through the records of patients treated by Dr. Marx between 2003 and 2008 to identify recreational alpine skiers who were seen within six weeks of a first-time ACL tear. To be included, skiers had to have ACL rupture documented on an MRI after the injury and a minimum of two-years of followup. Patients were excluded if they had injured ligaments in both knees. They identified 63 acute, first-time skiing ACL tears and 29 of these patients did not undergo an ACL operation.

The researchers then separated these 29 patients into two groups, those that had low-grade Lachman scores and negative pivot shift tests, indicating a potentially healed ACL, and those that had Lachman scores of 2+ and a positive pivot shift test indicating a damaged ACL. In the Lachman test, a physician uses his hands to try to pull the shin bone away from the thigh bone. If the ACL is intact, the bones won't move or will barely move, and the patient is deemed to have a score of 0-1. In a pivot shift test, a patient lies on his back while a physician lifts the patient's leg and uses his hands to place a rotational pressure on the knee. If the bones don't shift, the test is negative.

Six to 12 weeks after injury, 17 of the 29 skiers who did not have surgery had a Lachman score of 0 to 1 and a negative pivot shift test. Six of these patients were lost to followup, but 11 returned for a study-specific follow-up evaluation at more than two years post-injury. These patients completed questionnaires that gauged how well the knee was functioning, including the International Knee Documentation Committee subjective knee score and Tegner and Marx activity level scores. Patients provided information about how their ski accident had occurred. They also underwent Lachman and pivot shift tests as well as a KT-1000 test, a more objective test that uses an instrument to measure motions of the shin bone relative to the thigh bone.

Skiers described injuring their
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Contact: Phyllis Fisher
phyllis.fisher@gmail.com
212-606-1197
Hospital for Special Surgery
Source:Eurekalert

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